Ohangwena, Namibia — Français Italiano
Lazarus Fillemon's phone pings constantly. Where are you? When are you coming? I have a question. I have a story.
Lazarus, 30, is a youth ambassador for i-BreakFree, a community engagement program run by Global Fund partner One Economy Foundation in Namibia.
He spends his days driving vast distances across Ohangwena region's bright, dusty landscape, visiting schools, community gatherings and homes, holding frank discussions with adolescents and young people about preventing HIV, delaying sex, informed, consensual, safe sex when ready, alcohol and substance abuse - and much more.
He shares his phone number freely so that young people can reach him anytime.
The stakes are high.
Several years ago, Lazarus' good friend tested positive for HIV. They were scared - and didn't know what to do or who to turn to for support. That friend died soon after.
"That's how I started," Lazarus says. "I decided, this must be my passion - to be the voice of change."
Namibia is making incredible strides to end HIV as a public health threat.
As of 2024, 93% of people living with HIV in Namibia knew their HIV status, 96% of those people were on treatment and 98% of people on treatment were virally suppressed. The number of newly infected people per year nearly halved from 2013 to 2023, and the rate of mother-to-child transmission of HIV has gone down by 70% over the past two decades.
But hundreds of thousands of adolescent girls and young women - and their male sexual partners - still don't have the tools and support to prevent and treat the disease.
And they face staggering odds: Every week, about 4,000 adolescent girls and young women around the world are infected with HIV. In 2022, women in sub-Saharan Africa aged 15 to 24 were more than three times more likely to acquire HIV than their male peers. Gender-based violence and transactional sex due to economic vulnerability contribute to the problem.
Paulina Kamati works closely with Lazarus as an i-BreakFree youth ambassador. At 26, she feels lucky to live free of HIV and many of the hardships that trouble her community.
"[As girls], it was up to us to figure out our own things and be responsible for our own lives," she says. "Specifically in rural areas, people don't really know - where can I go as a young person to tackle these challenges I'm facing?"
Paulina in her community in northern Namibia's Ohangwena region. Global Fund partners in Namibia, including One Economy, Walvis Bay Corridor Group and government ministries, work together to provide a full spectrum of services to prevent adolescents and young people from acquiring HIV.
The risk of infection skyrockets when girls drop out of school, when boys refuse to use condoms for fear of being thought unmanly, or when young people are left to themselves while parents seek work elsewhere.
Investments from the Global Fund and the government of Namibia support health care that considers the whole person - young people's physical, mental and emotional well-being, and the obstacles they face to living safe and healthy lives.
Health assistant Cecilia hands out condoms and speaks with women who come to Walvis Bay Corridor Group's mobile clinic for advice about preventing STIs and other topics. i-BreakFree youth ambassadors, government-funded life skills teachers and youth-friendly clinical workers are trained to speak honestly, without judgement, to each young person. To learn about their families, experiences, fears and hopes - and give accurate, practical advice based on the complete context of their lives.
Several times per week, Paulina and Lazarus hold talks on HIV prevention and safe sex with hundreds of young people, followed by individual counseling sessions where they screen for gender-based violence, sexual abuse, neglect and other risk factors for HIV. They connect those who have experienced violence or are struggling with mental health challenges to counselors, social services and legal support, including the police. They refer young people to health clinics to test for and treat sexually transmitted infections (STIs) and access contraception and primary health care.
Lazarus and Paulina facilitate a group talk and individual counseling sessions on safe sex and preventing HIV with students at the Ounyenye Combined School in Ohangwena. Erica, a 23-year-old student, used to worry about becoming infected with HIV. She learned about pre-exposure prophylaxis (PrEP) from community workers visiting her neighborhood and asked for a referral so she could try it.
She met nurse Lucia Ndemuweda at the Walvis Bay Corridor Group Station Clinic, near Namibia's border with Angola. Lucia specializes in youth-friendly health services - forging meaningful connections with young people so they aren't afraid to seek out care.
"She was cool from the start," Erica says. "I just trust her, like a big sister."
Nurse Lucia counsels and provides PrEP to Erica at the Walvis Bay Corridor Group Station Clinic near Namibia's border with Angola. In rural and remote areas including parts of Ohangwena, where HIV prevalence among adolescent girls and young women is highest, each link in the chain - youth ambassadors, community health workers, principals, teachers, nurses - represents crucial opportunities to reach young people with tools that can transform their lives.
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With support from the Global Fund, partners in Namibia work in harmony to make sure the chain doesn't break - and that young people always have someone to turn to for support.
Erica has been on PrEP for two years now. She visits the Walvis Bay Corridor clinic regularly to collect her medication and brings friends to speak with Lucia and her colleagues about accessing contraceptives - including condoms - preventing and testing for STIs and much more.
"First I was that shy girl, but when I came here - they've changed my life," Erica says.
She is studying to be a nurse.
"I want to stand up and help [people] - health is the first, most important thing to have."
Written by Elise Walter. Photos by Karin Schermbrucker. With many thanks to colleagues at One Economy, Walvis Bay Corridor Group, Namibia's Ministry of Health and Social Services and its Project Management Unit.
