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International News

IRIN/PlusNews Examines Challenges of Providing Antiretrovirals in Namibia

September 18, 2008

Although more than half of HIV-positive Namibians thought to be in need of antiretroviral drugs are receiving them, Namibian officials are struggling to monitor patients and ensure they continue to receive the treatments, IRIN/PlusNews reports.

Gloria Billy, a UNAIDS program officer, said that the country's health sector lacks the medical personnel and systems to ensure HIV-positive patients stay on provided treatments, adding that there is "a lot of duplication" in various monitoring systems because of "parallel systems" of record keeping done by the Global Fund To Fight AIDS, Tuberculosis and Malaria and the President's Emergency Plan for AIDS Relief, the two donors supplying antiretrovirals to the country. UNAIDS is "trying to work closely with the health ministry so we have one system for monitoring and evaluation," Billy said, but a vacancy rate of 35% for physicians and 26% for nurses makes it difficult for physicians to manually fill out attendance records required to track patients.

Ndapewa Hamunime, head of HIV/AIDS case management in the Ministry of Health, said that 55,000 of the estimated 100,000 people in need of the treatments are receiving them, adding that Namibia would reach its goal of universal access to treatment "very soon." According to Hamunime, antiretrovirals are available at all of the country's 36 district hospitals and at some of the larger health centers, and only about 5% of people who started taking antiretrovirals have not adhered to their treatment. Billy said that the lack of an adequate monitoring system might be masking a higher default rate.

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According to IRIN/PlusNews, Namibia's shortage of medical personnel and lack of food security also contribute to the struggle to maintain antiretroviral adherence. Michael Mulondo, executive director of the Namibia Network of AIDS Service Organization, said that the "challenge" faced by many communities is poverty from lack of money and food. Hamunime said the lack of money for transportation and food prevents people living with HIV/AIDS from continuing treatment, which is "why we must strive to provide treatment at local clinics."

According to Hamunime, the Ministry of Health recently has started a strategy of "task-shifting" the initiation and management of antiretroviral treatments from physicians to nurses, which began this month in a pilot program supported by PEPFAR. Hamunime said Namibia would like to "follow the lessons learned" from countries with similar programs, adding that it is "especially important in remote areas where there are no doctors" (IRIN/PlusNews, 9/16).

Back to other news for September 2008


Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2008 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.



  
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This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.
 
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