A clinician's experience with the President's Emergency Plan for AIDS Relief in Nigeria: a transformative decade of hope.

Prior to the start of the President's Emergency Plan for AIDS Relief (PEPFAR), Nigeria struggled to fight HIV/AIDS. PEPFAR changed everything. I witnessed this change firsthand by directing the response to AIDS, first in my hospital in Jos, in central Nigeria, and now as Nigeria's HIV/AIDS coordinator. When the first AIDS case was diagnosed in Nigeria in 1986, my country had one of the world's poorest health systems, and as the pandemic spread, most Nigerians with AIDS died. Eventually, effective new drugs were developed, but they were too costly for all but a few Nigerians. Then there was a miracle: PEPFAR gave us resources, direction, and expertise to treat hundreds of thousands of people around the country. Today, Nigeria is providing treatment to 500,000 people with AIDS, and 80 percent of them receive treatment supported by PEPFAR. The US effort did more than help us treat people with HIV/AIDS; it also enabled Nigeria to strengthen its health system, improve care for pregnant women and infants, increase the provision of vaccinations, build modern laboratories, and train thousands of new health care workers and technicians.