Bitter pill: Namibia ARV supply to continue despite USAID cut

Despite concerns about longer queues and the risk of patients falling through the cracks due to the absence of U.S.-funded community health workers, the Namibian government insists it is ready to continue its antiretroviral therapy (ART) program independently.However, there are fears that Namibia - the first country in Africa and the first high-burden country globally to achieve the “silver tier” for eliminating mother-to-child transmission (MTCT) of both HIV and viral hepatitis B - risks backtracking on these gains.Responding to concerns about a potential reversal in progress due to the aid freeze, health ministry executive director Ben Nangombe reassured that Namibia’s sustainability roadmap has created a buffer against funding disruptions.He emphasised that the roadmap was introduced in anticipation of declining donor funding after Namibia was declared an upper middle-income country in 2012.“When we launched this, it was premised on the anticipation that we would encounter donor funding reduction. These measures will allow us to sustain the gains we have made in mother-to-child transmission. You must understand funding was already cut before, and we started to make serious preparations to absorb those cuts. Of course, there has been support from the U.S., and any gap that is created will have a negative impact. As it stands, the waiver allows us to continue for now; we are awaiting what the U.S. government says,” said Nangombe.Scope of USAID waiverThe USAID waiver allows the continuation of life-saving HIV care and treatment services, including HIV testing and counseling, treatment of opportunistic infections like TB, laboratory services, and procurement and supply chain management for medicines.It also covers MTCT prevention services, including test kits, medicines, and Pre-exposure Prophylaxis (PrEP) for pregnant and breastfeeding women.However, the waiver does not apply to services such as abortions, family planning (including sexual education, access to contraceptives, maternal and infant health), conferences, or programs supporting LGBTQ rights and transgender surgeries.Namibia's independent fundingWith an annual allocation of over half a billion Namibian dollars from the treasury, the Ministry of Health maintains that the country is well-positioned to sustain its ART initiatives.“We procure our ARVs 100%, and only a small amount is donated by the U.S. government,” Nangombe said. “The support from USAID was for programmatic areas such as prevention programs, adolescent sexual and reproductive health awareness, index partner testing, community health workers, and data collection. What will happen now is that people will have to wait longer for their medication and consultations because there will be fewer support staff.”Despite these challenges, Nangombe reassured that key populations, including LGBTQ communities, will still have access to essential treatments such as PrEP.“In Namibia, we provide health services without discrimination. If PrEP is needed and clinics have it in stock, whoever needs it will be able to access it,” he said.Impact on HIV care and preventionWhile USAID funding cuts will not affect Namibia’s ability to procure antiretroviral drugs, as the country independently funds 100% of its ARV supply, other areas of HIV care and prevention will feel the strain.Advocacy campaigns, awareness placards, and community programs previously funded by U.S. support are expected to disappear. Nangombe acknowledged that disruptions will be felt in clinics due to the absence of support staff such as quality assurance personnel, assistant pharmacists for ART programs, and clinical mentors treating opportunistic infections.In 2022, Namibia achieved over 95% coverage for first antenatal care visits, HIV and syphilis testing for pregnant women, and maternal antiretroviral therapy. With around 12,000 infants born annually to mothers living with HIV, Namibia’s MTCT rate of just 4.4% has been praised globally. - jemima@nmh-hub.com.na

Bitter pill: Namibia ARV supply to continue despite USAID cut

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Namibian Sun 2025-09-17

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Bitter pill: Namibia ARV supply to continue despite USAID cut

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Namibian Sun 2025-09-17

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