Namibia: Mother-to-Child Transmission of HIV in Namibia

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NAMIBIA is still battling to eliminate the high prevalence of HIV among pregnant women, despite 95% of them receiving antiretroviral therapy (ART).

Statistics of the Joint United Nations Programme on HIV-AIDS (UNAIDS) for 2019 show that about 12 522 pregnant women received antiretroviral drugs to prevent mother-to-child transmission (PMTCT), while 11 000 are still in need thereof.

It also indicates that 2 100 new HIV infections were averted due to antiretroviral treatment.

Mother-to-child transmission of HIV from an HIV-positive mother to her child happens during pregnancy, labour, delivery or breastfeeding.

Deputy minister of health and social services Esther Muinjangue last year said the country has improved from 88% in 2010 to 99% in 2019 in preventing mother-to-child transmission.

Executive director of health Ben Nangombe yesterday said attaining viral load suppression is critical to the elimination of mother-to-child transmission of HIV.

"HIV testing is offered to all pregnant women attending their first antenatal care contact. In addition, HIV retesting is recommended every three months to all pregnant and breastfeeding women with previous HIV-negative test results until the cessation of breastfeeding. All HIV-infected pregnant women are eligible for ART for their own health and PMTCT. By the end of 2020, ART coverage among HIV pregnant women was reported to be over 95%," he said.

Nangombe said Namibia has made significant strides in improving the prevention of mother-to-child transmission indicators and aims to be among the countries in Africa to be certified for eliminate it by 2024.

"As a country, Namibia has attained almost universal testing coverage for HIV in antenatal care settings and almost all those who test positive for HIV and are initiated on ARVs," he said.

PROGRESS MADE

The UNAIDS dictates that HIV is most commonly transmitted through heterosexual sex and from mother to child in Namibia.

Namibia introduced a prevention programme in 2002/03, and the component of early infant diagnosis using infant dried blood spot samples from HIV-exposed infants was added in 2005.

Over the years, these interventions have been scaled up nationwide to almost all public health facilities providing maternal and child-health services.

These services include antenatal care, labour and delivery, postnatal care and child health.

In 2013, the Ministry of Health and Social Services also introduced lifelong ART for all HIV-positive pregnant and breastfeeding women.

By 2014, PMTCT services were available in 94% of all public health facilities providing antenatal care and maternity services, and the health ministry also implemented a national strategy to reduce the prevalence of MTCT to less than 5% by 2017.

This is according to the National Institutes of Health Iournal ,titled 'National-level effectiveness of ART to prevent early mother-to-child transmission of HIV in Namibia'.

Currently, through the US President's Emergency Plan for Aids Relief (Pepfar), the United States Agency for International Development (USAID) and the health ministry continue to provide these services and counselling to pregnant women, their partners, children and families at faith-based facilities.

Last year, Pepfar increased its commitment to providing HIV-AIDS care across Namibia from N$1,2 billion to N$1,3 billion in 2021.

THE REST OF AFRICA

Sub-Saharan Africa accounts for eight out of 10 new infections among children on the continent. Research suggests that new infections among children in this region have fallen from 283 000 in 2010 to 126 000 in 2019.

The Conversation, an online news site, analysed the demographic and health survey data of 64 933 women from 16 sub-Saharan African countries.

The results show substantial differences between countries and sub-regions of sub-Saharan Africa in prenatal uptake of HIV testing.

Meanwhile about nine out of 10 women were tested for HIV as part of antenatal care in Rwanda, South Africa, Zambia, Uganda, Burundi and Zimbabwe, whereas only two out of 10 women were tested in Guinea, Benin and Mali.

Chad had the lowest coverage, with only one in 10 women tested.

The southern and eastern African sub-regions are the most affected by HIV in the world and are home to 20,6 million people living with HIV.

As a result, countries in the sub-region invest heavily in HIV prevention programmes. They provide free testing and treatment services.

Closing the gaps in coverage of HIV testing in sub-Saharan Africa will require, among other things, a massive investment in health systems in West and Central Africa.

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