6 Combat HIV/AIDS, malaria and other diseases

Where we are?

 community meeting
Raising community awareness on HIV/AIDS through the Community Capacity Enhancement project. Photo - UNDP

The three targets for this goal are, by 2015 to have halted and begun to reverse the spread of HIV, and the incidence of malaria and other major diseases, and by 2010, to have achieved universal access to treatment for HIV and AIDS for all those who need it. Of the six HIV and AIDS indicators that could be measured, trends from the early nineties show that Namibia had already achieved the ratio of 1.0 of school attendance of orphans to school attendance of non-orphans aged 14 years an below. Namibia is on target to achieve the 90 percent proportion of women aged 15 to 24 years with comprehensive and correct knowledge of HIV and AIDS, but not on target to achieve the same results for men of the same age group. The country is also on target to achieve the proportion (100 percent) of adults with advanced HIV infection who have access to antiretroviral treatment, although not target to achieve 95 percent of children with this access. The HIV prevalence target of 5 percent among the population aged 15 to 24 will also not be achieved, as it stood at 8.9 percent by 2012.

The overall national HIV and AIDS response in Namibia is guided by the respective short and medium term National Plans, the National Strategic Framework on HIV and AIDS and the National Policy on HIV and AIDS. In June 2011, Namibia committed itself to continuing its active response to HIV by endorsing the Political Declaration on HIV and AIDS: Intensifying our Efforts to Eliminate HIV and AIDS, at the UN General Assembly High Level Meeting on AIDS. The Political Declaration on HIV and AIDS runs parallel to the MDGs, with ten targets to be achieved by 2015, which support the achievement of MDG 6. In 2013, a consultative mid-term review of progress against these targets was completed and outlined the way towards achieving them, while the NSF mid-term review and recommendations will pave the way forward. The challenges in the overall response to HIV include financial and technical sustainability, effectiveness of treatment due to adherence issues, resistance and inadequate nutrition for PLHIV on treatment, slow roll-out of PMTCT Prongs 1 and 2, difficulties in implementation of PMTCT Option B+, slow uptake of voluntary medical male circumcision, and not responding appropriately to the key drivers of the epidemic, such as high risk populations. The overall monitoring and evaluation system is challenged by high staff turnover, inefficient use of available data, poor quality of data collected and absence of population based surveys and programme evaluations. Taking the above challenges into consideration, it is pertinent to continue with quality improvement activities for antiretroviral treatment, strengthen capacity of CSOs to support adherence to treatment, intensify efforts for elimination of MTCT by 2015, expedite implementation of the National Policy on Male Circumcision for HIV Prevention, continue with current prevention, treatment and care and support interventions for key populations, implement Government’s sustainability plan for HIV response, and strengthen the overall monitoring and evaluation system.

In addition to targets set for HIV, MDG 6 strives to halt and begin to reverse malaria mortality by 2015. Namibia is on track to achieve this and has already achieved a reversal in the incidence of malaria. This Goal also aims to have universal coverage of children using insecticide-treated bed nets. According to current trends, Namibia falls short of achieving this target by 2015. In relation to other major diseases, available data show that Namibia is doing well and had already achieved, by 2010, the target of 85 percent of tuberculosis cases treated successfully and reducing the number of people who died from tuberculosis to less than five. However, Namibia is not doing well in achieving the target on notification of tuberculosis cases as this stood at 545 per 100 000 population instead of less than 300.

Status at glance

MDG 6: COMBAT HIV AND AIDS, MALARIA AND OTHER DISEASES

HIV and AIDS

HIV prevalence among population aged 15-24 years (%)

8.2% (2006)

8.9% (2012)

5%

Not on target

Condom use at last high-risk sex for 15-49 years age group

     Women (%)

-

62.1% (2006/07)

85%

Lack of data

     Men     (%)

-

78.4% (2006)

90%

Lack of data

Alternative indicator

Condom use with non-cohabiting partner (15-49 years)

     Women (%)

51% (2000)

62.1% (2006/07)

n/a

No target set

     Men (%)

66% (2000)

78.4 (2006/07)

n/a

No target set

Proportion of population aged 15-24 years with comprehensive, correct knowledge of HIV and AIDS

    Women (%)

38.9% (2000)

64.9% (2006)

90%

On target

    Men (%)

50.7% (2000)

61.9% (2006)

90%

Not on target

Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years

0.92(2000)3

1.02 (2006)

1.0

Achieved

Proportion of population (adults and children) with advanced HIV infection with access to ARV drugs (%)

    Adults (%)

56% (2006/07)

81.5% (2011)

100%

On target

    Children (%)

88% (2006/07)

83.9% (2011)

95%

Not on target

MALARIA

Malaria mortality per 100 000 population

31 (1996)

0.4 (2012)

Halt and begin to reverse

On target

Proportion of children under 5 sleeping under insecticide-treated bed nets

10% (2000)

34% (2009)

Universal coverage by 2010

Not on target

Incidence of Malaria in 1 000 population

207 (1996)

1.4 (2012)

 

Halt and begin to reverse

Achieved

TUBERCULOSIS

TB cases notified per 100 000 population

657 (1997)

545 (2011)

<300

Not on target

% TB cases treated successfully

58 (1996)

85 (2010)

85

Achieved

Death rates (%) associated with TB

7 (2000)

4 (2010)

<5

Achieved

1.28 years
remaining
until 2015

1990 2015
Targets for MDG6
  1. Halt and begin to reverse the spread of HIV/AIDS
    • HIV prevalence among population aged 15-24 years
    • Condom use at last high-risk sex
    • Proportion of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS
    • Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years
  2. Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it
    • Proportion of population with advanced HIV infection with access to antiretroviral drugs