In Nigeria, the WHO World Health Report (2004) indicates an adult mortality²¹ rate per 1000 population of 453 for males and 392 for females. Life expectancy for males is 48.0; for females 49.6. Healthy life expectancy is 41.3 for males; 41.8 for females.²²

HIV/AIDS is a huge burden for sub-Saharan Africa. Throughout the region in 2003, an estimated 23-27 million people were thought to be living with the disease which also caused up to 2.5 million deaths. This represents a huge loss and impacts significantly on health systems and social and family structures.

Nigeria is one of the worst HIV/AIDS affected countries in Western Africa. Estimates suggest that in Nigeria, between 2.4 and 5.4 million people were living with HIV/AIDS at the end of 2003. In the same year, up to 490,000 adults and children are thought to have died from the disease (Table 2).

Table 2 Country HIV and AIDS estimates, end 2003

Source: 2004 Report of the global AIDS epidemic

UNAIDS reports:

While Nigeria's infection rate is lower than those of neighbouring countries, it nonetheless represents higher number of infections, given the large population; the country now has the highest number of HIV/AIDS-infected adults in West Africa. HIV/AIDS was first reported in Nigeria in 1986. Since then, the epidemic has been growing rapidly. In 2002 alone, more than 200 000 AIDS-related deaths occurred, and it was estimated that Nigeria had more than one million children orphaned by AIDS. Many factors that favour a rapid spread of the virus are prevalent in Nigeria, including high mobility, trafficking of young girls, marginalization of women, poverty, social and economic inequality, and specific socio-cultural practices. The "Next Wave of HIV/AIDS" report of the US National Intelligence Council predicts an estimated 10 million–15 million people living with HIV in the country by 2010.

Nigeria has put in place the necessary coordinating and decision-making bodies: the Presidential AIDS Council is chaired by the president of the country and includes the main line ministries. The federal coordination mechanism, the National Action Committee on AIDS (NACA), has been fully established with adequate infrastructure and capacity. Civil society participation in the fight against HIV/AIDS has been institutionalized through the establishment of coordination mechanisms such as the Network of People Living with HIV in Nigeria (NEPWAN), the Civil Society Consultative Group on HIV/AIDS in Nigeria (CiSCGHAN), the Faith-based Forum on HIV/AIDS, and the Nigeria Business Council on HIV/AIDS (NIBUCAA). The timeframe of the HIV/AIDS Emergency Action Plan (HEAP) 2000–2003 has elapsed and a review of the HEAP is being planned in the context of the participatory development of the new National HIV/AIDS Strategic Framework 2005–2009. Preparations for the drafting of the National Health Sector Strategic Plan and an advocacy strategy are well under way.²³