HIV/AIDS in Namibia

HIV/AIDS in Namibia is a critical public health issue. The prevalence of HIV in Namibia is among the highest in the world. Since 1996, HIV has been the leading cause of death in the country. Close to 17 per cent of the country’s children under the age of 18 are orphaned by at least one parent – mostly due to HIV. Consequently, life expectancy has declined since independence from 61 years (in 1991) to 49 years in 2001.

In Namibia, HIV is mainly spread through heterosexual sex, driven by high rates of multiple and concurrent partnerships, transactional sex and child abuse, misconceptions in the general population about the risk of contracting HIV, low and inconsistent condom use, high rates of alcohol abuse, a high rate of mobility and migration, and a decline in marital and cohabiting unions. Of greatest concern to many are the AIDS orphans and vulnerable children left behind in the trails of this disease.

Government Programmes

Surveys

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 encourage to use voluntary counselling and testing services, and that antiretroviral treatment be expanded to all parts of the country, especially the rural areas.

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

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. Yet, by the end of 2007, some 52,000 people in Namibia were receiving anti-retroviral therapy to combat HIV. 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

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.

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.)