Prof. John Idoko (2nd left) with other participants

With the increasing pace of healthcare challenges across the West African borders, stakeholders appear set to broaden the scope of health security and disease prevention, tracking and treatment in the sub-region. Paul Obi writes

The West African coastline stretching from Calabar, Lagos, Lome, Cotonou, Accra, Dakar to Abidjan is heavily populated amid several security challenges. One of such challenges is health security given the increasing outbreak of epidemics. To address this challenge, the sub-region leaders had in the early 2000 initiated the Abidjan-Lagos Corridor Organisation (ALCO) to checkmate health related crises that may hamper the West African health socioeconomic wellbeing.

According to the official ALCO report, the basic objective of ALCO is to “strengthen the capacity of airports, ports and land borders in view of the prevention, detection and response to risks of communicable diseases; strengthen the monitoring activity in border areas and along Benin and Togo portions of Abidjan-Lagos migration corridor and strengthen both intra and inter-countries communication and coordination for the prevention, detection and response to risks of communicable diseases.”
ALCO Secretariat has adopted “outreach programmes in favour of both mobile and key populations through public awareness-raising activities, HIV counselling and testing and STIs treatment among mobile and key populations.”

To this end, “reference of HIV+ cases to reference centres for ARV treatment and psychosocial support.” According to officials, By 2018, the target is to “ensure that all along the Abidjan-Lagos corridor: 80 per cent of truck drivers and other mobile populations, SW and their clients are attended to, MSW, 50 per cent of young girls/women, 30 per cent of IDUs adopt less risky HIV behaviours; 60 per cent of truck drivers and other mobile populations, 80 per cent of MSM, SW and their clients, 50 per cent of young girls and women, 30 per cent of IDUs know their HIV status: 100 per cent of local services have no discrimination attitude towards key populations (“Zero discrimination”) 95 per cent of PLHIV from ALCO’s target populations, benefit from psychosocial support.”

Presently, ALCO has also initiated programmes to tackle the challenges of Abidjan-Lagos corridor particularly STI and HIV/AIDS pandemics. The projects include “STI/HIV/AIDS outreach programmes for 33 882 (30 182 men and 3 700 women) truck drivers, apprentices of truck drivers, and other ports users distribution of 61 823 condoms (51 265 male condoms, 10 558 female condoms) making 2 422 711 (2 172 006 male condoms and 260 705 female condoms) the total number of condoms distributed from year 1 HIV testing for 3 408 (3179 men and 229 women) truck drivers and other ports users among which 33 have been tested HIV positive and referred to management sites.” Given that the target audience within the corridor has been mapped out, creating awareness and setting benchmarks become another task to ensure that the plan work. It is on that basis that stakeholders gathered in Abuja to brainstorm on the best strategies to fully implement ALCO projects.

To prioritise the project, the United Nations AIDS (UNAIDS), Economic Community of West Africa (ECOWAS) and the federal government last week unveiled a global health security plan targeting about 27 million people within the Abidjan – Lagos Corridor, made up of Nigeria, Ghana, Togo, Cote d’ Ivorie and Benin Republic. Participants from Federal Ministries of Transport, Foreign Affairs, ECOWAS, the World Bank, the Nigerian Customs Service and others attended the event, where deliberations of actualising the plan were brought to the fore.

Declaring open the annual statutory meeting of the Abidjan – Lagos Corridor Organisation Governing Board, Minister of Health, Prof. Isaac Adewole, said stakeholders are primarily concerned about tackling issues of health security, transport, HIV/AIDS and other socioeconomic challenges. The minister represented by Dr. Segilola Araoye, explained that “Abidjan – Lagos corridor is about 1022 kilometres, across the following five countries; Cote d’ Ivorie, Ghana, Togo, Benin and Nigeria. Every year, about 27 million passengers including many traders and 140,000 truckers use this road and ports.

“The impact of HIV/AIDS especially in the African region is exacerbated by socioeconomic and cultural factors while effecting control has been challenging because of weak health systems,” Adewole stressed.

The minister further stated that “the Abidjan – Lagos corridor handles 65 per cent of economic activity in the region, thus the importance of establishing and sustaining interventions in the corridor project cannot be overemphasised.”
UNAIDS Country Representative to Nigeria, Dr. Bilali Camara on his part harped on the need for concerted efforts across the West African region to ensure that health security challenges like HIV/AIDS within the corridor are addressed. Camara maintained that “what is critical is to ensure that health security, particularly in the area of HIV/AIDS becomes an integral part of the region’s socioeconomic policies.

Also, Director General, National Agency for the Control of AIDS (NACA) Prof. John Idoko stated that “key decisions have been taken to improve ALCO management and operations. We will take stock of them and see the way forward. Efforts of recovery of the arrears as at end of May 2016 are 94 per cent. Most of these arrears are paid. This undoubtedly, is a big relief for our Executive Secretariat, and I am appealing to the country members to continue with their efforts.”

Idoko observed that “currently, ALCO has received grants from the World Bank, the Global Fund, USAID, WAHO, UEMOA/AfDB, CDC, and UNEP. He added that “the activities being implemented are related to HIV/AIDS, ebola, health security issues, climate change, road infrastructure, road security and free movement of people and goods. The partnership and technical support with UNAIDS is still strong. This is the tangible proof that ALCO is gaining more and more confidence from our development partners,” the NACA DG stated. He went on to explained that “Additional Protocol of the Joint Declaration signed by the Heads of States of the five countries, aim to oversee the activities conducted by the Executive Secretariat and determine the orientations of the organisation.”

He said: “ALCO is yet to sign and receive a grant from the European Union to implement a project on road safety in Africa with 18 other entities. The partnership and technical support with UNAIDS is still strong. This is the tangible proof that ALCO is gaining more and more confidence from our development partners.” He added that “the critical issue of resources and fund mobilisation will still be part of our deliberations. ALCO is developing strategies and actions to attract and benefit of the financial assistance of various partners.” Idoko contended that the “challenge needs to be supported by respective countries by revising the level of their contribution to sustain ALCO.”

He held that “after more than 14 years of existence, and with the increase of activities of our institution, some changes and adjustments need to be done. No doubt that through the commitments of our governments, the donors will be with us for the resource mobilisation. Let me once again thank you for all your efforts and advocacies,” he said.

Speaking further, Idoko told the gathering that ALCO “new vision of search of expanding our activities beyond the Abidjan-Lagos corridor, and target other corridors, is still strong, and after 14 years of existence on the field, we think the time has come to take stock of the work done, and identify new perspective for our organisation. Indeed, during the past 15 years, some of the existing challenges along the Abidjan-Lagos corridor have changed in nature or magnitude. Similarly, the priorities and approaches of some of the players have changed.”

He maintained that the group is “envisaging to organise a regional forum which will aim to present the results of the work done by ALCO, put in perspective ALCO activities given the current situation, get opinions and recommendations of the stakeholders and partners for its future, identify emerging and future challenges it can handle.”

As stakeholders across board streamline on the best policies to tackle health security challenges within the corridor, the need for cohesion is paramount to achieving success. A more strategic means of addressing that should revolve around focusing on key population within the corridor. As earlier mentioned, transporters and traders constitute a chunk of the population in the area, and as such require more attention if tackling health security is a priority. With the focus on HIV/AIDS as a serious health security risk in the Abidjan-Lagos corridor, a concrete plan to tame the scourge is now practically in the offing. It should be one that addresses all the gaps in the fight against HIV/AIDS epidemic. A more worthy part to take therefore, is to walk the talk.