HIV/AIDS in Namibia

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HIV/AIDS in Namibia is a critical public health issue. HIV has been the leading cause of death in Namibia since 1996, but its prevalence has dropped by over 70 percent in the last 10 years(2006-2015) [1]. While the disease has declined in prevalence, Namibia still has some of the highest rates of HIV of any country in the world. In 2016, 13.8 percent of the adult population between the ages of 15 and 49 are infected with HIV [2]. Namibia had been able to recover slightly from the peak of the AIDS epidemic in 2002. At the heart of the epidemic, AIDS caused the country's live expectancy to decline from 61 years in 1991 to 49 years in 2001. Since then, the life expectancy has rebounded with men living an average of 60 years and women living an average of 69 years [1]

This increase in life expectancy is attributed to better sexual health education and an increased use of antiretroviral therapy in the infected population. Aid organizations and the Namibian Government have worked together to increase the use of antiretroviral therapies by those infected. In 2016 an estimated 64% of HIV positive people in Namibia are on ART, a number that has been rising by more than 3% a year since 2010.

However, the HIV epidemic has and still continues to affect the country in a large way. Close to 17 per cent of Namibia's children under the age of 18 are orphaned by at least one parent – mostly due to HIV.[3]

Disease Spread[edit]

Government programmes[edit]

Surveys[edit]

To determine prevalence, the Namibian government conducts a bi-annual serological survey among pregnant women, ages 15–49. The survey is done anonymously during routine antenatal care visits, which means that the results cannot be linked to anyone.

In 2008, Namibia had an HIV prevalence rate of 17.8% in adults ages 15 to 49, which is lower than 19.9% in 2006. However, the figure is still quite distressing. The peak occurred in 2002 when Namibia's prevalence hit 22%. The most recent survey (2008) further indicates that HIV prevalence is highest at 27% in the 30- to 34-year-old age group and is at its lowest (5.1%) among women aged 15–19 years. In response to this information, the Namibian Ministry of Health and Social Services recommended that prevention measures be intensified, that HIV/AIDS components be main-streamed into all development projects, that more Namibians be encouraged to use voluntary counselling and testing services, and that antiretroviral treatment be expanded to all parts of the country, especially the rural areas.[4]

Data compiled by the Ministry of Health and Social Services show that AIDS became the leading cause of death in Namibia in 1996. It is estimated that AIDS accounts for at least half of all deaths among individuals ages 15 to 49. However, there is great variation in HIV prevalence rates from region to region in Namibia. Infection rates also differ by gender, with UNAIDS estimating that women account for 58 percent of all HIV infections.

Treatment[edit]

Namibia is the second most sparsely populated country in the world. Providing comprehensive HIV/AIDS services to the mostly rural population requires a fully decentralized, community-based approach with strong policies and leadership from the central level. Insufficient numbers of skilled technical personnel and limited managerial capacity at all levels have exacerbated the challenges of decentralization, and access to services remains limited for those living in sparsely populated areas. As the country with one of the highest levels of income disparity in the world, poverty and household nutrition pose major challenges.[5] Yet, by the end of 2007, some 52,000 people in Namibia were receiving anti-retroviral therapy to combat HIV.[6] At the same time, mother-to-child transmission has also fallen dramatically – starting from just two hospitals in 2002. This is one of Namibia's greatest success stories of modern times.

Orphan care and support[edit]

Namibia's Ministry of Gender Equality and Child Welfare works closely with various development partners, non-governmental organizations and faith-based groups to implement the National Plan of Action for Orphans and Vulnerable Children.[7]

There are many organizations working in Namibia to provide services to orphans and vulnerable children. Two of the larger organizations are: Catholic AIDS Action (http://www.caa.org.na) and the Church Alliance for Orphans (CAFO)(http://www.cafo-namibia.org).

Although data on contribution of various development partners is inadequate, the US government's contribution is especially significant. Its PEPFAR program has allocated approximately $158 million for care and support to orphans and vulnerable children in Namibia since 2004. In 2007, 78,700 children received at least some assistance, although the total number of orphans is estimated to be about 250,000. (This number does include vulnerable children who are not orphans, which renders the total number of needy children much higher.)[8]

References[edit]

  1. ^ a b "Namibia - Institute for Health Metrics and Evaluation". www.healthdata.org. 
  2. ^ "GHO - By category - Prevalence of HIV among adults aged 15 to 49 - Estimates by country". apps.who.int. 
  3. ^ http://www.namchild.gov.na/library.php?po=186 National Demographic Health Survey, 2006
  4. ^ Ministry of Health and Social Services, Directorate of Special Programmes, Results of the 2008 HIV Sentinel Survey, 2008
  5. ^ http://www.pepfar.gov/countries namibia/index.htm "2008 Country Profile: Namibia". U.S. Department of State, 2008. Accessed August 25, 2008
  6. ^ World Health Organization, July 9, 2009 http://www.who.int/features/2009/hiv_namibia/en/index.html
  7. ^ http://www.namchild.gov.na/library.php?po=161 National Plan of Action for Orphans and Vulnerable Children (2006-2010)
  8. ^ Namibia’s Research Situation Analysis on Orphans and Other Vulnerable Children, Boston University Center for International Health and Development with Pharmaccess/Namibia. Final Report 2009