CDC in Namibia

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The Centers for Disease Control and Prevention (CDC) has collaborated with the government of Namibia since 2002, working closely with the Ministry of Health and Social Services (MoHSS) to support the national response to the HIV epidemic. As an implementing agency of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), CDC provides technical assistance and financial support for the rapid expansion of access to antiretroviral therapy (ART), HIV counseling and testing, early infant diagnosis (EID), and prevention of mother-to-child HIV transmission (PMTCT) services. CDC also supports the MoHSS in strengthening the public health system through assistance for health promotion, epidemiology, surveillance, laboratory, quality assurance, operational research, and workforce development.

HIV/AIDS

Namibia has one of the world’s highest HIV prevalence rates among adults (2009 estimate: 13.1%), with an estimated 178,000 living with HIV. The current national response is focused on the issues of an ongoing generalized epidemic. Programs are guided by a five-year national strategic framework for HIV/AIDS. CDC supports a comprehensive portfolio of HIV/AIDS prevention, care, treatment, strategic information, and systems strengthening programs described in the following paragraphs:

Prevention

CDC provides technical assistance to MoHSS programs and helps implement evidence-based prevention activities including prevention of mother-to-child transmission (PMTCT), male circumcision, blood safety, the national HIV testing program, and the reduction of alcohol misuse. Key achievements and activities include:

• PMTCT: High coverage of PMTCT and early infant diagnosis has been achieved and services have been integrated into routine antenatal care, maternity care, and postnatal care packages in the public healthcare sector.
• Circumcision: The national male circumcision policy and minimum package has been developed and expansion of services is underway.
• HIV Counseling and Testing: Rapid HIV testing is available nationwide through public healthcare facilities, stand-alone testing centers, and National Testing Day campaigns. CDC also supports the expansion of provider-initiated testing and quality assurance activities.
• Blood safety: All blood products are tested for HIV, Hepatitis B and C, and syphilis.

Care

CDC supports the continuum of care provided through PEPFAR to infected and affected adults and children via health facilities and community-based organizations. CDC provides technical assistance and financial support to the national EID, tuberculosis/HIV, and quality improvement programs. Key achievements and activities include:

• Access to care has been improved through support to facility-based and community-based outreach activities.
• Integrated management of adolescent and adult illnesses services was implemented.

Treatment

Namibia has adopted the WHO’s 2010 antiretroviral therapy (ART) guidelines. The initiation of treatment at a higher CD4 cell count is expected to improve the survival rate of people living with HIV and AIDS and increase the need for treatment services. CDC support through PEPFAR concentrates on improving the quality of HIV treatment, training, and mentoring. Key achievements and activities include:

• Treatment literacy has been expanded.
• Renovations and upgrades have been made to existing infrastructure.
• Antiretrovirals were procured and quality assurance support provided to the national bioclinical monitoring program.

Strategic Information

CDC supports the MoHSS to conduct HIV surveillance activities, monitoring and evaluation, research, and maintaining health information systems. Recent studies have looked at alcohol misuse as an HIV risk factor and the impact of clinic-based HIV prevention interventions. Key achievements and activities include:

• Support was provided for harmonized indicators and data systems.
• Data triangulation exercises were implemented.
• Support for biological and behavioral surveillance activities was provided.

Systems Strengthening

CDC provides technical leadership and direct assistance to MoHSS in strengthening the public health system and to improve laboratory systems and networks. CDC also supports integrated primary health care services to ensure that investments in HIV/AIDS are integrated with tuberculosis and maternal and child health services. Key achievements and activities include:

• Several laboratories have been renovated and lab operations have been strengthened through quality management technical assistance.
• Support for human resources has resulted in increased human resources capacity development and management.

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