The world has made enormous progress in reducing the impact of HIV over the past years.
On World AIDS Day (WAD), 1 December, UNAIDS highlighted that upholding the human rights of all people living with or at risk of HIV is vital for ending AIDS by 2030.
Globally, 30.7 million people - 77% of those living with HIV - were on treatment in 2023, up from just 7.7 million in 2010.
This has resulted in a dramatic decline in AIDS-related deaths, down by 51% over the same period.
In 2023, approximately 230 000 people were living with HIV in Namibia, with a prevalence rate of 9.7% among adults aged 15-49.
Women were disproportionately affected, making up 65% of those living with HIV and 4 000 (67%) of the 6 000 new infections.
Young people aged 15-24 were also significantly affected, contributing 2 100 (35%) new infections, with 81% of these among young women.
AIDS-related deaths are declining but still concerning, with 3 700 deaths in 2023 - a 33% decline in AIDS-related deaths since 2010, often linked to tuberculosis co-infection.
Namibia is nearing the 2025 Global 95-95-95 targets (95% PLHIV know their HIV status, 95% of those who know their status are on treatment and 95% of those on treatment are virally suppressed); with current rates at 93-95-98, the country aims to achieve 97-97-97 by 2028.
GENDER-BASED VIOLENCE
Despite the availability of a range of effective treatment and prevention tools, progress is still not on track to end AIDS as a global health threat by 2030.
Evidence shows that in at least 28 countries, new HIV infections are on the rise.
So how do we protect the gains already made against HIV and make further progress towards that vital 2030 goal?
A new UNAIDS World AIDS Day report released on 26 November, 'Take the Rights Path', shows that upholding human rights is the pathway to a robust and sustainable HIV response.
The world can end AIDS as a public health threat if the human rights of all people living with, and at risk of, HIV are protected.
Gender-based violence increases vulnerability to HIV.
Upholding the rights of women and girls is central to ending the AIDS pandemic.
Namibia faces significant challenges with gender-based violence (GBV), which has a direct impact on the HIV epidemic.
Nearly 35% of women experience intimate partner violence and/or sexual violence.
This not only affects their physical and mental health but also increases their vulnerability to HIV infection.
INVEST IN YOUNG PEOPLE
The denial of education and information puts people at risk.
There is an urgent need to invest in girls' education and to provide comprehensive sexuality education - a critical component of HIV prevention.
Barriers to health need to be dismantled.
For instance, many countries still have laws that prevent young people from being able to get tested to learn their HIV status unless they get parental permission.
This scares young people away and leads many young people to remain unaware of their HIV status.
Namibia is commended for its supportive laws for adolescent and young people's sexual and reproductive health rights, including the National Policy on Sexual, Reproductive and Child Health.
The Childcare and Protection Act (2015) allows HIV testing for children aged 14 and above.
Although many countries have made great progress in reducing HIV's impact among children, the commitment to protect all children living with and affected by HIV is not being met.
One in three children do not receive HIV testing within the first two months of life, the provision of lifelong antiretroviral therapy to pregnant and breastfeeding women living with HIV has not increased over the last decade, and HIV treatment coverage is markedly lower for children at 57% than for adults at 77%.
PROGRESS AND PROBLEMS
Namibia has made remarkable progress on eliminating mother-to-child transmission (MTCT) of HIV.
In May 2024, the World Health Organisation (WHO) awarded Namibia the Silver Tier status for its achievements in reducing MTCT of Hepatitis B and the Bronze Tier for HIV.
The criminalisation and marginalisation of groups of people, such as gay men, transgender people, sex workers, and people who use drugs also undermine efforts to end AIDS.
The anti-rights backlash which threatens to undo much of the progress made in the global AIDS response needs to be challenged head on.
To protect everyone's health we need to protect everyone's rights.
THERE IS HOPE
Worldwide, a number of divisive laws that impede the delivery of public health services to vulnerable groups of people are being removed.
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Namibia has made significant progress in addressing HIV-related punitive laws.
Notably, the Namibian High Court declared the law criminalising same-sex relationships unconstitutional in June 2024.
This decision is a major step towards reducing stigma and discrimination, which are significant barriers to accessing HIV services.
The new WAD report provides a clear roadmap: To end AIDS, take the rights path.
The report highlights that the global response is at a crossroads, with the potential to end AIDS by 2030 if human rights are protected and if marginalised communities are supported in accessing essential health services.
Discrimination, stigma and anti-rights policies hinder progress, creating barriers to HIV prevention, treatment and care.
Failing to act will result in higher infections, greater financial costs and human rights backsliding.
Urgent action is needed to meet the 2025 targets, or else millions will continue to acquire HIV and the financial and human toll of the epidemic will grow.
- · Medhin Tsehaiu is deputy regional director, UNAIDS Regional Office for East and Southern Africa.
