Trends in the HIV/AIDS epidemic
A little more than one-tenth of the world’s population live in sub-Saharan Africa which is home to almost 64% of all people living with HIV-24.5 million [21.6 million-27.4 million]. Two million [1.5 million-3.0 million] of them are children younger than 15 years of age. Indeed, almost nine in ten children (younger than 15 years) living with HIV are in sub-Saharan Africa. An estimated 2.7 million [2.3 million-3.1 million] people in the region became newly infected, while 2.0 million [1.7 million-2.3 million] adults and children died of AIDS. There were some 12.0 million [10.6 million-13.6 million] orphans living in sub-Saharan Africa in 2005.
An estimated 930 000 [790 000-1.1 million] adults and children died of AIDS in southern Africa in 2005-one-third of all AIDS deaths globally. Access to antiretroviral therapy has increased more than eight-fold since the end of 2003, with about 810 000 people on treatment in December 2005. About one in six (17%) of the 4.7 million people in need of antiretroviral therapy in this region now receive it. Progress is uneven, however, with coverage reaching or exceeding 50% in only three countries (Botswana, Namibia and Uganda) but remaining below 20% in most others. South Africa accounts for one-quarter of all people receiving antiretroviral therapy in sub-Saharan Africa.
Southern Africa remains the global epicentre of the epidemic. Almost one in three people infected with HIV globally live in this sub-region. About 43% (860 000 [560 000-1.4 million]) of all children (under 15 years) living with HIV are in southern Africa, as are approximately 52% (6.8 million [5.9 million-7.7 million]) of all women (15 years and older) living with HIV.
There are no clear signs of declining HIV prevalence elsewhere in southern Africa-including in Botswana, Namibia and Swaziland, where exceptionally high infection levels continue.
HIV/AIDS in Namibia
Namibia with an HIV prevalence rate of 21.3% is the sixth highest in Africa, after South Africa (21.5%), Lesotho (28.9%), Zimbabwe (33.7%), Botswana (37.3%) and Swaziland (38.8%). The first four HIV/AIDS cases were reported in Namibia in 1986. By the end of 2001, it was estimated by the Ministry of Health and Social Services (MOHSS) that there were about 230,000 adults and children living with HIV/AIDS.
In a sentinel sero-survey conducted in 2002, 22% of pregnant women were found to be infected with HIV (Ministry of Health and Social Services, 2004). The HIV prevalence among the pregnant women was highest in Katima Mulilo (43%), Oshakati (30%), Grootefontein (30%) and Walvis Bay (28%). In six out of every ten surveyed sites, HIV prevalence rates were above 20% and of all the sites surveyed, only one (Opuwo) had HIV prevalence rates below 10%.
According to USAID, Namibia’s life expectancy at birth is projected to drop from 61 years in 1991 to 40 by 2005. The World Bank warned that whereas Namibia’s life expectancy was 68.8 years before AIDS, it would reduce to 33.8 years by 2010. Namibia’s population growth rate would also slow to almost zero by the year 2010.
Data show that AIDS became the leading cause of death in Namibia in 1996. Namibia formulated a policy framework for the reporting and notification of HIV/AIDS. AIDS accounts for 46% of deaths among individuals aged 15-49 and between 50-70% of all public sector hospitalisations.
In 2002, the number of AIDS-related deaths were 16,000 and the number of orphans left by parents that had succumbed to AIDS was estimated at 108,470. The HIV epidemic in Namibia is predominantly due to heterosexual and mother-to-child transmission. The highest HIV prevalence rates are in six adjoining rural northern regions (Caprivi, Kavango, Ohangwena, Omusati, Oshana, Oshikoto) where over 50 percent of the population is concentrated.
UNAIDS stated that in parts of sparsely populated Namibia, the epidemic is as intense as in some of its neighbours, with HIV prevalence estimated at 19.6% [8.6%-31.7%] among adults nationally. In antenatal clinic attendees, HIV prevalence is surpassing 42% in Katima Mulilo (in the Caprivi Strip flanked by Angola, Botswana and Zambia) and ranging between 22% and 28% in the port cities of Luderitz, Swakopmund and Walvis Bay.
According to USAID, Namibia is one of the top five AIDS-affected countries in the world. Namibia`s epidemic is generalized and still on an upward trajectory.
A complex array of socio-economic and cultural factors specific to the Namibian context drives the trajectory: poverty; internal labour migration; the presence of major transportation corridors connecting Namibia to other high prevalence countries; sexual norms and attitudes; geographical inequities in access to services and information; and unequal power dynamics between men and women.
Women bear the greater burden of the HIV/AIDS epidemic, both as victims of the disease, and as the primary caregivers for others who are afflicted. Moreover, their unequal social and economic status places them at risk for earlier infection, leads to their stigmatization, and allows them to be unfairly blamed for transmission of the disease.