Background

Nigeria has the second highest burden of HIV in the world after South Africa representing 9.0% of the global burden of infection. The epidemic has however, continued to stabilise since 2011.  With a national population prevalence of 3.1%  the estimated number of people living with HIV in 2012 was 3.4 million people while 270,000 new infections occurred in that year. Seventy percent of the HIV infections were concentrated in 12 of the 36 states and the Federal Capital Territory; Abia, Anambra, Akwa-Ibom, Bayelsa, Benue, Cross-River, FCT, Kaduna, Kano, Nasarawa, Plateau and Rivers. Also the estimated number of AIDS-related deaths in the same year was 250,000. The country’s epidemic is mixed with both the general and most at risk populations contributing significantly to HIV incidence in the country. Where the epidemic is “mixed”, it is assumed that the epidemic in that region is driven by HIV transmission within networks involving key populations, and within segments of the wider “general” population among those who have multiple partners and/or belong to sexual networks that facilitate the spread of HIV.

HIV prevalence among the key populations is way higher than the national HIV prevalence. For example, the HIV prevalence among brothel-based FSWs ranged from 23.5% in Lagos to 49.2% in Abuja; among MSM the prevalence ranged from 3.0% in Cross River to 25.0% in Lagos; and among IDU from 3.0% in Cross River and Lagos to 10.0% in Kano. Populations with high-risk behaviours for HIV infection (FSW, IDU and MSM) are responsible for 40.0% of new infections, although they constitute only 3.4% of the populations. The pattern of infection within Nigeria has also changed over time, shifting from affecting only a few specific populations in a handful of states (localized epidemic) to a more expansive epidemic in all states (generalized epidemic). Also, the country has identified localized population specific epidemics within a generalised epidemic in some states.

The prevalence of HIV amongst female IDUs is almost seven times higher than that of male IDUs [21.0% vs 3.1%] and higher amongst female police officers [4.5% vs 2.0%] when compared to their male colleagues. The priority given to the prevention of new infections has been rightly emphasized by the country's 2009 National HIV/AIDS Policy, the 2010-2015 National HIV/AIDS Strategic Plan, and the President’s Comprehensive Response Plan for HIV/AIDS in Nigeria. The National Prevention Plan provides a guide on HIV prevention programming in order to ensure a coordinated, well resourced, effective and efficient response.

The National Strategic Plan (NSP-II) identified the need “to reposition prevention of new HIV infections” as the cornerstone of the national HIV and AIDS response. Thus greater focus will be placed on scaling-up HIV prevention services that enable individuals to maintain their HIV negative status as well as improve access to quality treatment and care services for people living with HIV thereby reducing the potentials for transmission of HIV infection. The National HIV Prevention Plan has been developed for this purpose.

Context of the policy review:

Individual risk behaviors including injecting drug use are influenced by structural elements that include, inter alia, law, mechanisms for its enforcement and its application in Court. To illustrate, the likelihood of an injecting drug user (IDU) reusing contaminated needles to inject drugs is greater where possession of injection paraphernalia can lead to arrest than in jurisdictions where he/she can procure a syringe without being apprehended by the police. Further, laws have a direct bearing on public health policy and programming.

Certain effective interventions for reducing harm may not be permitted or closed down for ‘want’ of legal sanction. On the other hand, if facilitated by law, interventions can be initiated and scaled up to reduce individual vulnerability and promote public health. This is especially true for services like needle-syringe exchange and opioid substitution treatment programmes that are crucial to break the chain of HIV transmission among people who inject drugs (PWIDs). It is against this background that the review of legal and political concerns related to PWUD/PWID Harm Reduction needs to be commissioned by the United Nations Office on Drugs and Crime.

The research, review and analysis is aimed at examining the current legal and policy regime on drug use in Nigeria. It is expected to inform stakeholders working with people who inject drugs in Nigeria of the legal hurdles in introduction, implementation and scale up of proposed interventions. The report is expected to be the basis for future advocacy with the drug and HIV sectors and to improve engagement with relevant stakeholders for increased roll out of effective interventions among people who inject drugs in the country.

Duties and Responsibilities

The technical consultant(s) will work closely with the Program Coordination department of NACA, UNODC and the National Prevention Technical Working Group (NPTWG) to conduct the review.

Duties and Responsibilities:

  • Carry out a desk review of current policies and existing legislation pertaining to drug control (drug use including the use of prescription drugs, use of injection paraphernalia), and HIV sectors (drug use and sex work, issues around condom distribution and possession etc.,) in Nigeria;
  • Through a participatory process involving national counterparts from the drug demand reduction, HIV /AIDS and drug law enforcement sectors in Nigeria and working closely with key stakeholders, document existing concerns and imbalances pertaining to laws, policies and interventions in the Drug Control and HIV sectors of Nigeria, particularly, related to PWID harm reduction approaches;
  • Collect secondary data on current situation assessments of populations burdened by drug use and consequences (affected and afflicted) with special emphasis on vulnerabilities and identify examples of best practices in terms of responses embedded in an enabling environment in the region;
  • Suggest a framework to facilitate enabling policy environment and ways forward to review existing legislation to ensure that a “Rights Approach” be adopted in a programming that reaches out to the drug using populations in order to reduce their vulnerability;
  •  Provide continuous feedback and engagement with the NACA and UNODC technical team as the need arises in the review process;
  • Submit a draft report, final report and Powerpoint presentation to the Program Coordination department of NACA for sharing with stakeholders.

Reporting Mechanisms:

The consultant will report to the Regional Advisor, HIV and AIDS, UNODC and liaise with the Assistant Director, Sexual Prevention, Program Coordination department, NACA and the core team involved with the policy review.

Competencies

  •  In-depth understanding of the challenges within development and public policy work.;
  • Excellent skills in  conducting research, synthesis and comprehensive analysis studies;
  •  Excellent Communication / report writing skills;
  • Excellent interpersonal and cross-cultural communication skills;
  • Displays cultural, gender, religion, race, nationality and age sensitivity and adaptability;
  • Highest standards of integrity, discretion and loyalty.

Required Skills and Experience

      Education:

  • Advanced degree in public health, health planning, health economic, social sciences or other related field.

Experience:

  • A minimum of 10 years’ experience and extensive knowledge with country-specific laws, policies and programs on drug use and HIV/AIDS with reference to Nigeria;
  • Experience in conducting, drafting, reviewing legal and policy reviews on a country or regional level;
  • Experience in conducting research, synthesis and comprehensive analysis studies.

Language:

  • Fluency in English.