Namibian non-governmental organisations (NGOs) warn that HIV infections are rising, with three new cases reported daily, following the withdrawal of the United States Agency for International Development (USAID) over a year ago.
USAID stopped funding Namibian NGOs after United States (US) president Donald Trump cut support from the US President’s Emergency Plan for AIDS Relief (Pepfar) last January.
“The government has not stepped in to fill the gap and the cases are going up,” Out-Right Namibia spokesperson Agapitus Hausiku says.
Out-Right is one of the leading lesbian, gay, bisexual, transgender, queer/questioning, intersex and other (LGBTQI+) human rights-based organisations in the country.
The cut has impacted HIV programmes that alleviate overcrowding at public healthcare centres by providing HIV testing, condom distribution, prevention education and treatment to sex workers, youth, long-distance truck drivers and the LGBTQI+ community.
The NGOs have to apply to the Global Fund, which has to cover HIV-AIDS and tuberculosis, malaria and pay healthcare professionals.
In 2024 Namibia received approximately N$737 million for its HIV-AIDS initiative, while non-profit organisation IntraHealth reportedly received over N$165 million last year.
The Namibia Planned Parenthood Association (Nappa), an organisation that offers HIV testing, counselling and data collection, says it started recording three to four HIV cases a day for the past year.
Nappa and Outright Namibia say alongside the increase in new infections, they have also observed a rise in unwanted pregnancies due to a lack of condoms at public health clinics.
The Ministry of Health and Social Services has not responded to questions sent by The Namibian on 12 March.
ZERO CONDOMS
Nappa Walvis Bay-based youth agent Bernard Kamtoto says the health organisation has seen an increase in HIV infections among the youth due to the lack of condoms from the government.
“Between three to four people approach our clinics and even myself daily, that they are HIV positive and would like us to assist them.
“There are no condoms in clinics or services. The ministry is quiet and all of us are in the dark,” he says.
Kamatoto, who works with both in-school and out-of-school youths, says the withdrawal of funding has impacted their work of promoting pre-exposure prophylaxis (PrEP), abstinence and safe sex among the youth.
PrEP is a daily medication or injection used by HIV-negative individuals to prevent HIV infection.
Despite PrEP being available, Kamatoto says the lack of awareness among young people has also led to the rise of unwanted pregnancies.
OUTDATED STATISTICS
In addition, organisations like Nappa say they are working with outdated HIV statistics from 2022 due to a lack of proper data from the health ministry, last conducted four years ago.
“The ministry is supposed to release the statistics every two years, but we are sitting with data from 2022,” Kamatoto says.
When approached for comment, Intrahealth’s spokesperson Nandeekwa Tjiurutue could not provide a response.
Positive Vibe Namibia spokesperson Andre Kloppers says HIV infections are on the rise due to the lack of HIV preventative campaigns that target youth through billboards, pamphlets and social media – even before USAID pulled its funding.
Hausiku says the HIV rate is increasing due to organisations not having the financial resources to continue operations and assist with HIV prevention education.
He says organisations such as Project Hope Namibia have scaled down, while Regain Namibia has completely closed its doors.
Efforts to reach Project Hope Namibia and Regain Namibia were to no avail.
PATIENTS DEFAULTING ON TREATMENT
Hausiku highlights that the number of HIV treatment defaulters has also increased as Out-Right does not have the funding to remind people with HIV to return to clinics and refill their medications.
HIV treatment defaulters are people with HIV who stop taking their antiretroviral medication on a daily basis and do not return to clinics.
Hausiku explains that the state health facilities are overwhelmed by the number of patients they now have to accommodate.
SCALING DOWN
Equal Rights for All Movement executive director Rachel Gawanas says the funding cuts have forced the organisation to scale down, creating challenges for it to support Namibia’s sex worker movement, particularly HIV prevention and treatment programmes targeting highly mobile populations.
The youth-led social movement targets grassroots communities.
“Equal Rights Namibia has experienced significant financial strain following the funding cuts.
The organisation had to navigate a difficult transition period marked by limited operational resources, forcing it to scale down certain activities while attempting to maintain essential services for the communities it supports,” she says.
Gawanas notes that the funding cut has put pressure on government public health efforts on strengthening HIV prevention and providing healthcare access to sex workers, truck drivers and the LGBTQI+ community.
She highlights that the sudden withdrawal has led to structural challenges that have put pressure on government systems to immediately absorb civil society organisations that specialised in reaching marginalised communities.
She calls for collaboration between the government and community-led organisations to ensure that essential services previously supported by donors are sustainably integrated into national health responses.
“These groups remain critically important in the national and regional HIV prevention landscape due to the nature of cross-border mobility and the associated vulnerabilities that can increase the risk of HIV transmission.
Programmes supporting the sex worker movement have provided targeted services such as HIV testing, condom distribution, prevention education, and referrals for treatment and care,” she says.
Walvis Bay Corridor Group (WBCG) spokesperson Maria Paulus says adjustments in donor funding have affected their programme implementation timelines, however, they will continue to work with the government to provide essential mobile health services to vulnerable populations along Namibia’s transport corridors and communities.
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