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Sunday 21 April 2019
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AIDS: New report shows Namibia is winning battle

It is easy to be cynical about Namibia’s battle to win the battle against HIV/AIDS, but at the same time the success rate in reducing the disease is one worth noting and there is no denying the success.  According to a new report by the United Nations Programme on HIV/AIDS (UNAIDS), Namibia has made significant progress in the AIDS response, thanks largely to the renewed political commitment for increased investment in the AIDS response and by so doing putting Namibia on the path to ending AIDS as a public health threat by 2030.  President Hage Geingob and the Executive Director of UNAIDS, Michel Sidibé, this week launched the report titled ‘Get on the Fast-Track: the life-cycle approach to HIV’.   Speaking of Namibia’s successes in the AIDS battle, UNAIDS said: “The uptake of Global Fund grant by civil society organisations has improved, with a particular focus on community interventions aimed at enhancing adherence to treatment and engagement of people living with HIV.” One of the most effective elements of the global HIV strategy has been the reduction in mother-to-child transmission, which Namibia has listed as one of its priority areas. Namibia is one of the countries that adopted the 2016 World Health Organisation guidelines as well as one of the few to adopt develop and adopt an investment case.
But while the national picture might look positive, local health activists warn that much remains to be done. Namibia’s prevalence rate is estimated at 14.6%, placing it among the top 10 countries in eastern and southern Africa. The number of people living with HIV in Namibia is estimated at 210 000, with 149 829 of them on anti-retroviral treatment.  “Just under two years ago, 15 million people were accessing antiretroviral treatment, today more than 18 million are on treatment and new HIV infections among children continue to fall. Now, we must ensure that the world stays on the fast-track to end the AIDS epidemic by 2030 in Namibia, in Africa and across the world,” Geingob said at the launch.   The report shows that countries are getting on the fast-track, with an additional one million people accessing treatment in just six months (January to June 2016).  By June 2016, around 18.2 million people had access to the life-saving medicines, including 910 000 children, double the number recorded five years earlier. If these efforts are sustained and increased, the world will be on track to achieve the target of 30 million people on treatment by 2020.
Sidibe said despite the huge strides countries have made to fight the pandemic, resources will continue to be scarce and the need to show a return on investment will be stronger than ever before. “And with no reduction in the global number of new HIV infections among adults in the past five years, and rising numbers of new infections in some regions of the world, we need to realise that if there is a resurgence in new HIV infections now, the epidemic will become impossible to control,” he cautioned. The report noted that key challenges in the bid to win the fight include HIV testing among pregnant women, mother-to-child transmission during breastfeeding and low levels of paediatric diagnosis and slow initiation of treatment. It also indicates that AIDS-related deaths globally among children dropped from almost 250 000 in 2000 to 110 000 in 2015. The report contains detailed data on the complexities of HIV and reveals that girls’ transition to womanhood is a very dangerous time, particularly in sub-Saharan Africa. “Young women are facing a triple threat. They are at high risk of HIV infection, have low rates of HIV testing, and have poor adherence to treatment. The world is failing young women and we urgently need to do more,” said Sidibe.
HIV prevention is key to ending the AIDS pandemic among young women and the cycle of HIV infection needs to be broken, states the report. Recent data from South-Africa shows that young women are acquiring HIV from adult men, while men acquire HIV much later in life after they transition into adulthood and continue the cycle of new infections.   The report also shows that the life-extending impact of treatment is working. In 2015, there were more people over the age of 50 living with HIV than ever before — 5.8 million.  The report highlights that if treatment targets are reached that number is expected to soar to 8.5 million by 2020. Older people living with HIV, however, have up to five times the risk of chronic disease and a comprehensive strategy is needed to respond to increasing long-term health-care costs.
The report also warns of the risk of drug resistance and the need to reduce the costs of second- and third-line treatments.  It also highlights the need for more synergies with tuberculosis (TB), human papillomavirus (HPV) and cervical cancer, and hepatitis C programmes in order to reduce the major causes of illness and death among people living with HIV.  In 2015 alone, 400 000 of the 1.1 million people who died from an AIDS-related illness died from TB, including 40 000 children. “The progress we have made is remarkable, particularly around treatment, but it is also incredibly fragile. New threats are emerging and if we do not act now we risk resurgence and resistance. We have seen this with TB. We must not make the same mistakes again,” said Sidibe. Get on the fast-track: the life-cycle approach to HIV outlines that large numbers of people at higher-risk of HIV infection and people living in high-burden areas are being left without access to HIV services at critical points in their lives, opening the door to new HIV infections and increasing the risk of dying from AIDS-related illnesses.
The report further examines the gaps and approaches needed in HIV programming across the life cycle and offers tailored HIV prevention and treatment solutions for every stage of life. “Ending AIDS is possible only if we join hands, by each doing what is within our scope, creatively and aggressively embracing the 90–90–90 targets,” said Eunice Makena Henguva, Youth Economic Empowerment Project Officer for the Namibian Women’s Health Network.




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