Liberia Lacks Updated National HIV Data, As Gov’t’s Institutions Remain Silent

By: Siaway T. Miapue/LHRJN Fellow

Like other countries, Liberia is expected to end AIDs by 2030 as a public health threat.

For this to happen, a country must have updated national statistical data that informs the country about the current status of the HIV situation.  

This will help identify the patterns of the spread of the virus, to assist decision-makers, academics, development partners, and implementing partners to track progress in the HIV response.

Also, an up-to-date national data is critically important because it provides a wide range of monitoring and impact evaluation indicators to measure whether the country is making progress in the national HIV response or not, for redress.

But in Liberia, updated national HIV data is surprisingly lacking. Throughout, the country has relied on data from the 2013 Liberia Demographic and Health Survey to guide program implementation in the HIV response.

The 2019/2020 new Liberia Demographic and Health Survey (LDHS) conducted by the Liberia Institute of Statistic and Geo-Information Services (LISGIS), does not have national data for HIV.

Like other LDHS in the past, national HIV data for the country is not reflected in the 2019/2020 LDHS.

Sadly, the country is currently using the Joint United Nations Programme on AIDS (UNAIDS) annual spectrum estimates to guide the national HIV response.

For instance, it is the UNAIDS’ spectrum estimates that Liberia is using to project that 34,358 persons are living with HIV, with a prevalence of 1.5%.

Another conflicting issue is that the UNAIDS’s spectrum estimates data is being used (quoted) alongside the 2013 LDHS data which indicates that there are 35,000 persons living with HIV, with a prevalence of 2.1%.

This means that Liberia is using two different data for the national HIV response of the country, a situation that stakeholders consider embarrassing for the country.

Relevant government institutions including the Liberia Institute of Statistics and Geo-Information Services (LISGIS), National AIDS Commission (NAC), National AIDS and STIs Control Program (NACP), Ministry of Health (MOH), and National Public Health Institute of Liberia (NPHIL) are yet to explain what led to the omission of national HIV data from the current LDHS.

Accusing fingers are being pointed at LISGIS, the lead government institution for conducting LDHS and all national surveys for the country.

The current LDHS only considered data for Fertility, Family Planning, Nutrition, Women’s Empowerment, Domestic Violence, and Maternal and Child Health Mortality, while data on HIV is not reflected. This could be one possible hindrance to achieving the 95-95-95 target by 2030 because there is no national data to be used for success measuring.

An investigation launched into this saga by a media watchdog, Liberia Health and Rights Journalist Network (LHRJN) revealed that, different government institutions have not provided clear answers why the country does not have updated HIV data in the current LDHS for program implementation.

When contacted, Mr. Joseph Weah, Head of Communications at the National Public Health Institute (NPHIL) referred our reporter to the Ministry of Health (MOH) on grounds that NPHIL has no information regarding the omission of HIV data in the 2019/2020 LDHS.

Assistant  Health Minister for Vital Statics, Chea Stanford Wesseh when contacted, told our reporter that he could not provide further information on the issue because he was not authorized to speak.

Mr.  Chea Stanford Wesseh, Assistant  Health Minister for Vital Statics

Mr. Wesseh instead referred our reporter to the Ministry’s Communication Office.

The Ministry’s Director of Communications, Felecia Gbesioh expressed shock that the National data for HIV would be omitted from the LDHS, describing it as impossible.

Madam Gbesioh told our reporter to engage LISGIS for details. 

“I spoke with the guy in charge, and he said you should check with LISGIS because that is impossible,” Madam Gbesioh told our reporter in a text message.

At LISGIS, the Director for Social Statistics, Germue Gbarwoquiya revealed that they do not have control over the blood component of the LDHS.

According to Mr. Gbarwoquiya, they (LISGIS) completed the analysis proposes of the data which was required of them.

“LISGIS does not do test. We did the analysis and report, but on the blood component we don’t play with blood”, Gbarwoquiya said.

“You can contact the National Public Health Institute (NPHIL) and they will tell you the issue of the blood samples as it relates to the HIV testing,” Mr. Gbarwiquiya told our reporter in a telephone interview.

For National AIDS Commission and National AIDS and STIs Control Program, they have intentionally preferred not to comment on this issue that directly falls under their jurisdiction as per the law.

NAC and NACP are afraid that commenting on this grave issue that borders on the credibility of the National HIV response, they will apparently be reporting LISGIS for the negatives.

The two institutions turned down several interview appointments arranged and agreed on between them and the Liberia Health and Rights Journalists Network.

Meanwhile, some civil society actors in Liberia have expressed concern over the reported HIV national data omission from the current LDHS for the country.

Mr. Batie Nah, Monitoring and Evaluation Officer at the Liberia Network of Persons Living with HIV (LibNeP+), said the organization is not aware of the omission of HIV data in the LDHS. He acknowledges its importance.

“I am wondering why that component of the data should be extracted from the demographic and health survey.  HIV is one of the diseases that is being treated at health facilities,” Mr. Nah said.

Mr. Nah said, “I can’t speak to that till I do a follow-up…. it’s from your email that I got to know.”

 

 

 

He however said, “The information we use now is mainly from LISGIS’ report and demographic health survey”.

Mr. Maxwell W. Monboe, Coordinator of Liberia Initiative for the Promotion of Rights, Identity, Diversity, and Equality (LIPRIDE) acknowledged the omission of the HIV data from the 2020 LDHS.

“For us what we normally do is that we do not wait for the government’s data to do our work because all by ourselves we have this community that we are committed to working with,” Monboe said.

“It concerns us because we depend on this national data to inform our programs implementation and project writing,” Maxwell said.

From all indications, accusing fingers continue to be pointed at LISGIS because it is the institution that has the legal authority to preside over/ensure the conduct of all national surveys for the country.

Creditable information gathered by the LHRJN indicates that reagents and other commodities for testing blood samples to determine HIV prevalence was delayed due to LISGIS’ negligence.

As a result of this negligence, the LDHS for 2019/2020 does not reflect HIV prevalence in the country.

Our information further indicates that LISGIS did not make effort as a lead agency for statistics in the country to ensure that blood samples collected and sent to the Liberia Bio-Medical Research Institute were tested.

Our investigation also unearthed that due to LISGIS’ negligence, those blood samples are still languishing at the warehouse of the Liberia Bio-Medical Research Institute.

This could be a waste of donors’ money because there is no guarantee that those blood samples are still useful. Those samples have been kept at the Liberia Bio-Medical Research Institute for nearly four years now.

The 2019-2020 Liberia Demographic and Health Survey (2019-20 LDHS) was implemented by the Liberia Institute of Statistics and Geo-Information Services (LISGIS).  Data collection lasted from October 2019 to February 2020.

Funding for the 2019-20 LDHS was provided by the United States Agency for International Development (USAID).

Additional funding was provided by the United States Centers for Disease Control and Prevention (CDC), the United Nations Population Fund (UNFPA), UNICEF, the Embassy of Ireland (Irish Aid), the United Nations Development Programme (UNDP), the World Health Organization (WHO), UN Women, and the Global Alliance for Vaccine and Immunization (GAVI).

ICF provided technical assistance through The DHS Program, a USAID-funded project providing support and technical assistance in the implementation of population and health surveys in countries worldwide.

This fellowship story was supervised by the Liberia Health and Rights Journalists Network (LHRJN), with funding from the American Jewish World Service (AJWS).