Nigeria will double the number of government centres where AIDS patients can get free drugs in the next three months as part of a major drive to widen access to treatment, the government anti-AIDS agency said on Friday.

Nigeria started distributing anti-retroviral drugs (ARVs) for free this month from 33 government health facilities, scrapping a 1,000 naira ($8) fee that patients previously had to pay for subsidised drugs.

“We plan to add an additional 33 centres in the first quarter,” said Babatunde Osotimehin, chairman of the National Action Committee on AIDS (NACA).

Nigeria has 3.5 million people living with HIV/AIDS, the third-highest number in the world after India and South Africa, and an estimated 40,000 people on ARVs.

Osotimehin said he was confident that NACA’s target of getting 250,000 people on the drugs by the end of this year would be met, partly because the drugs can now be obtained free of charge.

“There will be greater equity. We are not yet in a position to have universal access, but the fact that poor people will be able to access drugs is a major progress,” he said.

Two thirds of Nigeria’s estimated 140 million people live on less than a dollar a day, and AIDS charities had long argued that the 1,000 naira fee put the drugs beyond the reach of many.

Osotimehin said it would now be easier for people to take the right doses of drugs without interruption, which is important because taking insufficient, irregular doses causes the body to develop resistance to ARVs.

“The issue of reduced response to drugs over the long term can be brought down to the bare minimum,” he said.

EXTRA COSTS

Relief organisation Medecins Sans Frontieres said the free drugs programme did not go far enough because patients would still have to pay for expensive tests that are vital to monitor treatment, and for drugs for opportunistic infections.

In response, Osotimehin said the government would also subsidise those tests and drugs but it was still studying how it would do so. Treatment for tuberculosis, one of the more common illnesses among AIDS patients, was already free in Nigeria.

He said full HIV/AIDS care including tests was free for children and pregnant women - a key part of efforts to prevent the transmission of the virus from mother to child.

Funding for the free care is coming from government and from major donors such as the World Bank, the U.S. government and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Osotimehin defended NACA’s work against criticism from a Global Fund panel which said late last year it would recommend terminating two grants worth $80 million over five years, after they have run for only two years.

The panel said it had “serious concerns” about NACA’s ability to implement the grants, citing missed targets, questionable data, failure to set up a computerised accounting system and low disbursement.

Osotimehin said all of those concerns had been addressed. The problems stemmed from a long delay in starting work, due to bureaucracy at NACA and at the Global Fund, he said.

“Because of the delays it was difficult to meet targets,” he said, adding that the agency now had the required computerised system and had sent full accounts of funds disbursed and drugs delivered to Global Fund headquarters in Geneva.