Namibia: Progress Made Against HIV/Aids Fragile

30 January 2023

Health Minister Dr Kalumbi Shangula said over the past two decades, the number of annual deaths among people living with HIV has more than halved, and the rate of new HIV infections is almost four times lower.

He said the number of new HIV infections among children under the age of one has also decreased by over 90%, adding that hospitals and health systems are no longer overwhelmed by HIV/AIDS. "However, intensive campaigns about HIV prevention have reduced over time, and some people have become complacent about behaviours that can spread HIV, such as having multiple sexual partners and having unprotected sex. This has led to a reduction in the use of simple, effective prevention measures, such as using a condom," Shangula said recently in light of the current public discourse on the procurement of clinical supplies.

He added that without critical HIV prevention and control measures, the epidemic could spiral out of control. "More than 13% of Namibian adults are HIV-positive. This translates into 219 000 people living with HIV in the country. Most people living with HIV, who are taking their medication correctly every day, are stable and will live long, healthy lives," stated the minister. "Approximately 33 000 people living with HIV either do not know their status or they do not have the virus under control. This means they may transmit the infection to sexual partners. HIV-positive pregnant and breastfeeding mothers can pass the virus to their children."

Shangula pointed out that condoms give people a simple and effective way to reduce the risk of HIV exposure, reduce the spread of sexually transmitted infections, and they reduce unplanned pregnancies.

The international targets for the elimination of HIV/AIDS as a public health threat by 2030 are premised on the 95-95-95 fast-tracked targets.

Shangula said Namibia now stands at 98- 92-93. This means that in the country, 98% of persons who are HIV positive know their status; 92% of them have been initiated on treatment, and 93% of those who have been initiated on treatment are virally suppressed. Viral suppression is important because a person who is virally suppressed is less likely to transmit the virus to a partner during sexual intercourse. "It costs less than a dollar to prevent HIV infection using a condom. However, it costs approximately N$300 000 to treat an HIV-positive client over an average lifespan," he said.

Shangula stated the critical keys to maintaining epidemic control include finding people living with HIV who do not know their status. "When found, they are to be linked to treatment. This will improve their health and prevent them from transmitting the virus unknowingly to others." He further said if people living with HIV are adherent to current anti-retroviral regimens, the virus becomes suppressed and eventually undetectable in their blood. This means they cannot transmit the virus to others.

"Prevention is crucial - and that includes Voluntary Medical Male Circumcision (VMMC), condom use and pre-exposure prophylaxis (PrEP). These measures are effective biomedical prevention methods to stop the spread of the virus," he stated.

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