Lagos State Government Increases Financial Commitment to Fight HIV

Two state agencies in Lagos, Nigeria received increases in government funds to fight HIV in 2021. The Lagos State AIDS Control Agency (LSACA) received a 7.2 percent budget increase—NGN 683 million (USD 1.7 million) in 2021 compared to NGN 637 million (USD 1.6 million) in 2020. Meanwhile, the Lagos state government allocated NGN 15.9 million (USD 39,750) to the State AIDS and STI Control Programme (SASCP).
Nigeria’s HIV response is heavily funded by donors (80 percent). Yet, declines in donor funding, coupled with high HIV prevalence rates (1.4 percent), makes increasing domestic government funding for HIV a critical step toward Nigeria being able to sustainably finance its HIV response and achieve epidemic control. Sustainable HIV financing will require both the government’s financial commitment to HIV control through improved budget appropriation and the release of appropriated funds. The latter requires a thorough understanding of public financial management processes and the capacity to develop compelling funding requisition memos to ensure that funds are released.
Since 2019, the USAID-funded Health Policy Plus (HP+) project has provided technical support to LSACA and SASCP to strengthen their capacities in public financial management to improve both budget appropriation and the release of appropriated funds. First, HP+ undertook a rapid assessment of public financial management processes that identified bottlenecks impeding budget allocation and releases for HIV interventions. The assessment found gaps in staff capacity that often led to unrealistic budgets that were misaligned with government policy. There were also delays in obtaining funds, mostly due to the poor quality of fund requisition memos and inadequate follow-up with the relevant stakeholders to ensure timely releases.
To address these gaps, HP+ worked with LSACA and SASCP to strengthen their capacity to develop program-based budgets and submit evidence-based and compelling fund requisition memos. The training also highlighted the need to engage a more diverse set of government entities, such as the Ministry of Economic Planning and Budget, Ministry of Finance, State Treasury Office, and other relevant program and budget officers, to facilitate the release of the funds.
HP+’s support to LSACA and SASCP provided staff with a thorough understanding of public financial management processes and the skills to apply them and advocate for the timely release of funds. In addition to the increase of LSACA’s 2021 HIV budget, HP+’s support resulted in the release of NGN 173 million (USD 421,068) in 2020 and NGN 300 million (USD 730, 282) to date in 2021.
The increase in Lagos state’s HIV budget and release of funds signifies greater government ownership and commitment to the fight against HIV. Improved public financial management reduces the state’s dependence on donors and draws the state closer to achieving financial sustainability for its HIV response. Together, these gains will help ensure that more people living with HIV will have access to HIV services and treatment, an imperative to ending the epidemic.