As we mark World AIDS Day this week, it’s time to pause and ask why HIV-AIDS remains one of Namibia’s most stubborn health concerns.
People are still getting the virus, with poverty driving unprotected sexual intercourse between young women and older men.
The last AIDS conference on the African continent, in Durban in 2016, brought a renewed focus, and political will, to halt the “blesser” phenomenon, with funding for prevention among young women.
Namibia also received funding for projects which summarily had their lifelines cut when the United States Agency for International Development, the main implementer, was dissolved by United States (US) president Donald Trump’s administration earlier this year.
With long-acting HIV prevention injectables now set to reshape the response to HIV-AIDS, Namibia risks being left behind by high costs, donor politics and slow regulatory action.
A POWERFUL INJECTABLE
Still, the new injectable is a powerful intervention. Data from neighbouring South Africa shows that the long-acting injection has not been shown to fail.
It involves two jabs a year to stay protected. However, there’s a catch: the cost.
The drug has also not been approved by Namibia yet, although the manufacturer, Gilead, has applied for registration.
There has been no announcement from the Medicines Regulatory Council of when they plan to issue a response.
In addition, former health minister Richard Kamwi said the cost may be prohibitively high for Namibia (an annual cost of nearly half a million Namibian dollars per patient).
So for now, this jab is out of reach.
As we’ve done before, Namibia awaits assistance from our “development partners”, a euphemism for hand-outs.
NO LONGER ‘AFRICA LIGHT’
In an unrelated development, we also made it onto an ignominious list of African countries that could be barred from entry to the United Kingdom, pending approval of certain conditions.
No longer an upper middle income country since the World Bank downgraded us earlier this year, we hope to meet eligibility for a free shipment of the jab.
We are no longer the “Africa light” country we believed ourselves to be.
On the other hand, we have achieved more than most on the HIV-AIDS front.
We were among the first countries to meet the United Nations Joint Programme for HIV-AIDS 90-90-90 targets.
We also have put more than 20 years of US tax dollars, funnelled through the Pepfar programme, to use in giving people living with HIV a second chance at life.
Our antiretroviral (ARV) clinics beat those in Europe in terms of knowledge of health providers and types of drugs given.
CONSIDERATIONS
Will Namibia be on the long awaited list of 10 African countries that will have the jab paid for by the US government?
We were on the first list of Pepfar countries in 2003, which ushered in the era of ARVs.
The word from US senior adviser Brad Smith is that consideration for the new jab will be based on the countries with the largest number of HIV patients as a percentage of population.
Given Namibia’s stellar achievement in bringing the epidemic under control, will we meet the criteria?
There may be another factor hindering us: we have very low potential for unleashing the next pandemic.
According to Health Policy Watch, an independent global health outlet, the US is providing funding for African countries where there is potential for a new viral pandemic.
Zambia, for instance, which is close to the tropics and has an abundance of forests.
Smith visited Zambia earlier this year to discuss further US funding agreements.
Zambia will receive aid in exchange for access to surveillance databases so that the US will be ready for any new virus of pandemic potential.
OUR HOPE
Our numbers tell our story. We are a country where all sectors pulled together to tackle AIDS.
May the memories of those Namibian activists who campaigned to raise awareness and bring access to treatment be an inspiration to us now.
- – Pancho Mulongeni is a Namibian writer and health communications specialist.
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