16th International AIDS Conference


Toronto, Canada - August 13 - 18, 2006

REACHING THE WHO/UNAIDS 3×5 INITIATIVE TARGET IN NAMIBIA – WHAT DID IT TAKE?

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. ThAb0202

Katjitae I.1, Mugala-Mukungu F.1, Goraseb M.2, Damesyn M.3, Matroos E.4, Hamineme N.2, Kaura H.5, Gaeseb J.6, Stevens L.7, Shihepo E.2, Forster N.8, Kenyon T.3
1 Ministry of Health and Social Services, Department of Medicine, Katutura State Hospital, Windhoek, Namibia, 2 Ministry of Health and Social Services, Directorate of Special Programs, Windhoek, Namibia, 3 Centers for Disease Control and Prevention, Global AIDS Program - Namibia, Windhoek, Namibia, 4 Ministry of Health and Social Services, Health Information System, Windhoek, Namibia, 5 Namibia Institute of Pathology, Windhoek, Namibia, 6 Ministry of Health and Social Services, Pharmaceutical Services, Windhoek, Namibia, 7 International Training and Education Center on HIV/AIDS, Windhoek, Namibia, 8 Ministry of Health and Social Services, Health Services, Windhoek, Namibia

ISSUES: The WHO/UNAIDS "3 by 5" initiative was a global target to provide three million people living with HIV/AIDS with antiretroviral treatment (ART) by 2005. This presentation reports on Namibia’s progress towards meeting its target.

DESCRIPTION: Namibia has an estimated 52,000 people in need of ART. In early 2003, the MoHSS began mobilizing resources to introduce ART in government hospitals through the public health system. Technical and management structures were established, projections and resource requirements were estimated, lab and infrastructural improvements began, and drugs were competitively procured.

LESSONS LEARNED: ART began in mid-2003 and reached 32(94%) of 34 public hospitals by 2005. Uptake increased significantly with additional personnel from the US President’s Emergency Plan for AIDS Relief (PEPFAR) beginning in January 2004. GF support began in June 2005. By December 2005, 16,119 patients had been started on ART, exceeding the "3×5" target of 14,500. Patient characteristics included median age 34 yrs, 64% female, 14% pediatric, and median adult baseline CD4 132 cells/mm3 with 84% having CD4<200. To date, 93% are reportedly alive, 5% died, 2% defaulted, and 1% unknown. Including 4,000 on ART in the private sector, 38% of patients in need were on ART by 2005 compared with 6% in 2003. Governmental leadership combined with donor support contributed to this achievement. Health worker attitudes towards HIV/AIDS care improved with ART availability. Consensus-building around one national guidelines, rollout plan, training program, information system, and technical support facilitated rollout. Data from the information system were used by MoHSS to identify resource gaps and mobilize additional resources through PEPFAR and GF.

RECOMMENDATIONS: Next steps include decentralizing ART from hospitals to health centers and transferring more tasks from doctors to nurses; increasing emphasis on quality; and development of a human resource plan to meet Namibia’s needs for sustaining ART in the future.

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2006-08-13
ThAb0202

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