Namibia
The first case of AIDS in Namibia was reported in 1986. The epidemic grew rapidly until 2002 and has since show signs of stabilisation. According to UNAIDS/WHO HIV in Namibia was estimated at 15.3% in 2007. The estimated number of people living with HIV at the end of 2007 was 200,000 including 14,000 children.
The most recent ante-natal clinic (ANC) HIV surveillance survey found 19.9% of women attending ANC were HIV positive1. There was a rapid increase in ANC HIV prevalence from 4.2% in1992 to 22% in 2002
HIV prevalence is increasing in some regions and in some age groups. For instance there is great disparity between the ANC HIV prevalence reported in Katima Mulilo (39.4%) and that reported in Opuwo and Gobabis (7.9%)
The number of people on antiretroviral treatment was 52,000 at the end of 2007, up from 9,000 in 2004.
Key elements of the national response
Namibia launched its first HIV/AIDS Medium Term Plan (MTPI) in 1992 under the coordination of the National AIDS Control Programme. This was later replaced by the National AIDS Co-ordination Programme (NACOP) in 1999. Namibia is currently formulating its fourth Medium Term Plan (MTPIV).
Namibia’s Vision 2030 regards HIV as one of the most serious threats facing the country and highlights the need to mainstream HIV programmes to effectively meet the resulting development challenges. Consistent with the goals of Vision 2030, the country's response to the epidemic has intensified considerably in recent years. The Namibian government is fully committed to tackling the epidemic through a multi-sectoral approach. This is reflected in the Medium-Term Plan III (MTP III) for the period 2004-2009 which places particular emphasis on the importance of effective monitoring and evaluation of the epidemic. The overarching goal of the MTP III is to reduce HIV incidence through achieving five key strategic results:
- Enabling Environment -- People living with or affected by HIV enjoy equal rights in a culture of acceptance, openness and compassion
- Prevention -- Reduced new infections of HIV and other sexually transmitted diseases
- Access to treatment, care and Support Services -- Access to cost effective and high quality treatment, care and support services for all people living with or affected by HIV
- Impact Mitigation Services -- Strengthen and expanded capacity for local responses to mitigate socio-economic impacts of HIV
- Integrated and Co-ordinated Programme Management at all levels – Effective management structures and systems, optimal capacity and skills, and high quality programme implementation at national, sectoral, regional and local levels
Key Achievements
- A Response Monitoring and Evaluation Unit was established in 2002 with the primary mandate of monitoring and evaluating the implementation of HIV response strategies at national and regional levels. The national M&E plan was developed in line with MTP III and launched in September 2006
- The Third Medium Term Plan (MTPIII) for 2004-2009 was launched in 2003
- The National Policy on HIV/AIDS was launched in 2007
- The Ministry of Defence and the National Defence Forces launched the Military Action and Prevention Programme in 2001
- Provision of antiretroviral treatment began in mid-2003 and reached 32 (94%) of 34 public hospitals by 2005 and has reached all hospitals and some clinics by mid-2007
Key Challenges
Emerging challenges to be considered from 2008 include: strengthening national coordination; scaling up HIV prevention; addressing the financial sustainability of the national response; addressing human resources issues; and mitigating the deepening socioeconomic impact of the epidemic.
The NACOP needs to be strengthened in order to guide and manage the national response to HIV. As suggested by the reviewers of the MTPIII, it may be useful to revise the national coordination architecture to strengthen a multisectoral response.
Namibia has made significant progress in the provision of HIV treatment. However, to effectively tackle the pandemic and make treatment sustainable, it is critical to develop and implement a massive HIV prevention programme. Less than 15% of the national budget has been allocated to health and the HIV budget accounts for only a small percentage of it. The Namibian government needs to increase ownership and investment in the response to AIDS.
As Namibia is considered a lower middle income country, many bilateral donors are phasing out, which increases dependence on the Global Fund and PEPFAR. Limited human resources constitute one of the biggest obstacles to scaling up the national response. The Education and Training Sector Improvement Plan is a potential long term solution, as well as submitting short- to medium-term plans to the Global Fund.
The biggest obstacle to increasing access to the provision of antiretroviral treatment, prevention of mother-to-child transmission and voluntary counselling and testing is human capacity. Significant obstacles are also distance, the negative attitude of health professionals and high fees.
There is concern that the country relies heavily on donor funding to finance its national response. In 2007, the HIV/AIDS Partnership Forum engaged the National AIDS Council Chair on this and on the need to step up HIV prevention.
Civil society, including umbrella organisations, needs more financial and technical support in order to strengthen and scale up efforts.
Useful Links
National Strategic Plan
National Strategic Plan
PMTCT and Paediatric Care and Treatment Fact Sheet
Contacts
UNAIDS Country Office
Private Bag 13329
Windhoek
Namibia
Tel: +264 61 204 6221
Fax: + 264 61 204 6203
Global Report 2008 Data
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