Health & Education

Namibia Fighting HIV

African nation winning war with AIDS

Is Namibia starting to gain control over its HIV epidemic?

Ranked fifth worldwide for the prevalence of HIV, Namibia is making considerable progress in the battle against the virus.

It has become the first nation in Africa to reach the UN target of virally surpressing 73% of the HIV-affected population. Results have been elaborated based on a nationwide HIV survey carried out in 2017 called the Namibia Population-Based HIV Impact Assessment (NAMPHIA).

Partially funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the Center for Disease Control and Prevention (CDC), over 23,000 adults aged 15-64 took part in the latest assessment, providing blood samples for home-based HIV testing.

After that, all HIV-seropositive results were further examined to detect viral load at a central laboratory.
Estimates indicate that 77.4% of the population living with HIV have a viral load below 1,000 copies/ml, which is scientifically considered as insufficient to transmit the virus to another person.

At the recent International AIDS Conference held in Amsterdam in July, Bernard Haufiku, Namibia’s Minister of Health and Social Services, proudly stated: “An AIDS-free generation is within our reach.”

The nationwide sampling sheds some more light in this direction. According to NAMPHIA data, 86% of the HIV-infected Namibians are aware of their serological status, 96% of these are receiving retroviral treatment, and 91% of those under treatment currently have suppression levels of the virus.

These results make Namibia very close to reach the UNAIDS 90-90-90 targets for 2020, which aim to have 90% of population living with HIV diagnosed, to have 90% HIV-positive people under treatment, and to have 90% of people who are in treatment virally suppressed.

NAMPHIA shows that currently Namibia stands at 86-96-91, having surpassed already two of the targets three years ahead of schedule and nearing the first one.

Additionally, if we look at segmented data by sex, UNAIDS targets have already been met in the case of Namibian women, who have a higher prevalence rate than men, 15.7% versus 9.3%.

Talking about this success, Mr. Haufiku stated: “We are on track to control the HIV epidemic with our HIV treatment and prevention programs. The suppression of the virus is a marker of effective treatment and will help us with prevention because, as we all know, treatment by itself is prevention.”

According to experts, Namibia’s accomplishment has been achieved thanks to governmental commitment, access to data, and community-based HIV initiatives.

The broad political support enabled strong partnerships to be established in the country as in the cases of PEPFAR and NAMPHIA. Through this joint work the population-based survey was able to identify areas within the Namibia with the highest prevalence rates, which were subject to further actions involved relevant stakeholders, including the Ministry of Education and NGOs.

The Namibian government’s budget to prevent HIV accounts for 64% of the all funds used for HIV programs, and for almost all purchases of antiretroviral medication.

UNAIDS data shows that there are currently over 200,000 people living with HIV in Namibia and that the prevalence rate for those aged between 15 and 49 is 12.1%, making it fifth highest rate in the world just behind Swaziland, Lesotho, Botswana, and South Africa.

However, Namibia’s surprising figure is that 96% are receiving treatment, which is up from the 51% rate registered in 2010.

There is also a new diagnostic method being developed by CDC focused on sexual partners of people recently diagnosed with the virus. Known as index partner testing, this new approach is able to identify individuals with potentially undiagnosed HIV who do not remain under treatment and as a result constitute the highest risk vectors of further transmitting the virus.

According to the local NGO DAPP (Development Aid from People to People) that has introduced partner testing in Namibia, “Carrying out HIV testing around the people found HIV+ has been found to be an efficient approach in testing other vulnerable family members and other sexual partners against contracting the HIV infection.

TCE (Total Control of the Epidemic) uses the Index Testing approach in screening for HIV the other couple, children and sexual partners in ensuring no-one is left behind in ART Treatment.”

Prevention efforts have also been complemented by promoting condoms and offering oral pre-exposure prophylaxis (PrEP), a preventive medication, to highly vulnerable groups.

But work still needs to be done, especially in addressing structural social issues leading to gender inequality, which might be making women more vulnerable to contracting the virus.

In any case, Namibia is closer than ever to tackling the country’s primary cause of death.