Monday, December 09, 2024

Namibia: To End Aids, Protect Everyone's Human Rights

8 December 2024
The Namibian (Windhoek)

The world has made enormous progress in reducing the impact of HIV over the past years.

On World AIDS Day (WAD), 1 December, UNAIDS highlighted that upholding the human rights of all people living with or at risk of HIV is vital for ending AIDS by 2030.

Globally, 30.7 million people - 77% of those living with HIV - were on treatment in 2023, up from just 7.7 million in 2010.

This has resulted in a dramatic decline in AIDS-related deaths, down by 51% over the same period.

In 2023, approximately 230 000 people were living with HIV in Namibia, with a prevalence rate of 9.7% among adults aged 15-49.

Women were disproportionately affected, making up 65% of those living with HIV and 4 000 (67%) of the 6 000 new infections.

Young people aged 15-24 were also significantly affected, contributing 2 100 (35%) new infections, with 81% of these among young women.

AIDS-related deaths are declining but still concerning, with 3 700 deaths in 2023 - a 33% decline in AIDS-related deaths since 2010, often linked to tuberculosis co-infection.

Namibia is nearing the 2025 Global 95-95-95 targets (95% PLHIV know their HIV status, 95% of those who know their status are on treatment and 95% of those on treatment are virally suppressed); with current rates at 93-95-98, the country aims to achieve 97-97-97 by 2028.

GENDER-BASED VIOLENCE

Despite the availability of a range of effective treatment and prevention tools, progress is still not on track to end AIDS as a global health threat by 2030.

Evidence shows that in at least 28 countries, new HIV infections are on the rise.

So how do we protect the gains already made against HIV and make further progress towards that vital 2030 goal?

A new UNAIDS World AIDS Day report released on 26 November, 'Take the Rights Path', shows that upholding human rights is the pathway to a robust and sustainable HIV response.

The world can end AIDS as a public health threat if the human rights of all people living with, and at risk of, HIV are protected.

Gender-based violence increases vulnerability to HIV.

Upholding the rights of women and girls is central to ending the AIDS pandemic.

Namibia faces significant challenges with gender-based violence (GBV), which has a direct impact on the HIV epidemic.

Nearly 35% of women experience intimate partner violence and/or sexual violence.

This not only affects their physical and mental health but also increases their vulnerability to HIV infection.

INVEST IN YOUNG PEOPLE

The denial of education and information puts people at risk.

There is an urgent need to invest in girls' education and to provide comprehensive sexuality education - a critical component of HIV prevention.

Barriers to health need to be dismantled.

For instance, many countries still have laws that prevent young people from being able to get tested to learn their HIV status unless they get parental permission.

This scares young people away and leads many young people to remain unaware of their HIV status.

Namibia is commended for its supportive laws for adolescent and young people's sexual and reproductive health rights, including the National Policy on Sexual, Reproductive and Child Health.

The Childcare and Protection Act (2015) allows HIV testing for children aged 14 and above.

Although many countries have made great progress in reducing HIV's impact among children, the commitment to protect all children living with and affected by HIV is not being met.

One in three children do not receive HIV testing within the first two months of life, the provision of lifelong antiretroviral therapy to pregnant and breastfeeding women living with HIV has not increased over the last decade, and HIV treatment coverage is markedly lower for children at 57% than for adults at 77%.

PROGRESS AND PROBLEMS

Namibia has made remarkable progress on eliminating mother-to-child transmission (MTCT) of HIV.

In May 2024, the World Health Organisation (WHO) awarded Namibia the Silver Tier status for its achievements in reducing MTCT of Hepatitis B and the Bronze Tier for HIV.

The criminalisation and marginalisation of groups of people, such as gay men, transgender people, sex workers, and people who use drugs also undermine efforts to end AIDS.


The anti-rights backlash which threatens to undo much of the progress made in the global AIDS response needs to be challenged head on.


To protect everyone's health we need to protect everyone's rights.


THERE IS HOPE

Worldwide, a number of divisive laws that impede the delivery of public health services to vulnerable groups of people are being removed.

Namibia has made significant progress in addressing HIV-related punitive laws.

Notably, the Namibian High Court declared the law criminalising same-sex relationships unconstitutional in June 2024.

This decision is a major step towards reducing stigma and discrimination, which are significant barriers to accessing HIV services.

The new WAD report provides a clear roadmap: To end AIDS, take the rights path.

The report highlights that the global response is at a crossroads, with the potential to end AIDS by 2030 if human rights are protected and if marginalised communities are supported in accessing essential health services.

Discrimination, stigma and anti-rights policies hinder progress, creating barriers to HIV prevention, treatment and care.

Failing to act will result in higher infections, greater financial costs and human rights backsliding.

Urgent action is needed to meet the 2025 targets, or else millions will continue to acquire HIV and the financial and human toll of the epidemic will grow.· Medhin Tsehaiu is deputy regional director, UNAIDS Regional Office for East and Southern Africa.


Uganda: Minimising Gender-Based Violence Is Key to Reducing HIV/Aids By 2030


8 December 2024
Nile Post (Kampala)
By Robert Kigongo

Human rights framework strengthening, multi-sectoral and multilateral collaborative efforts, toll-free lines, and adding HIV protection measures among top priority health components.

I joined the AIDS Information Centre in Kampala to flag off "The 16 days of Activism against Gender-Based Violence" However was mesmerized to learn about the nexus between Gender-based Violence and HIV/AIDS.

Gender-based violence is exposing millions of people to HIV/AIDS across the world depriving them of good health and well-being.

GBV is one of the worst forms of human dehumanization and denigration that is underscoring the observation of human Rights and reduced inequalities.

The nexus between Gender-based violence and HIV is that both calamities pose the greatest threat to public health robbing us of our right to a good healthy living, happiness, hope, faith, and sustainable economic growth.

While sharing with Maureen Namubiru (Not real name) one of the young girls living with HIV, I learn of the increasing number of new HIV infections and a decrease in retention and care especially among younger people and intimate lovers.

I have come to notice that Gender-based Violence is a criminally underrated factor causing HIV/AIDS spikes, the earlier we mitigate the underlying issues causing GBV the earlier we achieve UNAIDS 95,95,95 Targets by 2030.

According to UNAIDS, there are "38 Million people living with HIV globally, while in Uganda there are 1.5 people" There have been progressive efforts to minimize the epidemic in the last 41 years but the continuous gender-based violence has failed the world to miss out on the first 90,90,90 targets in early 2000's.

While gender-based violence cuts across all genders women and girls have been more prone and vulnerable to severe adversaries exposing them to high-risk sexual behavior causing STIs and HIV/AIDS.

In our close conversation with Maureen, she shared that she contracted HIV at an early age after having forced sex with a maternal uncle who was thrice older than her.

Forced sex is seasoned with physical rape, defilement, and marital rape which often happens without condoms and consent leading to genital skin tearing through which the HIV penetrates the bloodstream.

According to UNAIDs "50 percent of women worldwide report being physically abused by their intimate partners"

Gender-based violence in African families spills over into interpersonal child sexual assault that eventually exposes minors to high-risk sexual behaviors.

GBV consequentially has exposed many young girls and adolescents to early child marriages, sex trafficking, prostitution, violent retaliation, and child poverty.

Gender-based violence has led to irreconcilable family breakups, parent absenteeism, infidelity, and unprotected sex eventually exposing adolescent girls and boys to desperate economically motivated sex for survival.

The UNAIDs came with 10,10,10 and 95,95,95 targets but Gender-based

Violence is posing the biggest threat towards the second 95 and the third 95 due to the trauma and stigma caused.

For instance, GBV is heavily threatening retention and care of viral suppression while many victims have missed out on antiretroviral treatment.

Unprecedently girls and women living with HIV are experiencing gender disparities and violence is crippling the third 10 of the UNAIDS GBV targets.

Gender-based violence bleeds sexual violence, trauma, depression, mental health, and stigma that affects viral load and treatment response failing all existing efforts and investments dwindling HIV by 2030.

My neighbors have also heard reported cases that men and boys go through terrible horror partner relationships categorically stating how have become punching bags for women and domesticated in homesteads, while some minor boys have equally faced sexual assault from men or fellow slightly older age mates in schools, orphanages and abusive homes.

Therefore, there is an urgency to deconstruct harmful sexually abusive stereotypes, negative social norms, and practices.

Some of the leading causes of gender-based violence must be confronted with an iron hand to achieve the UNAIDS 95, 95, and 95 Targets.

Failure to address gender-based violence risks a continued culture of violence against children, adolescents, and partners to HIV/AIDS risk behaviors.

I propose intensive training of local council leaders, security organs, and media on identifying and monitoring hotspots for gender-based violence and the provision of response services.

Supporting agribusiness and start-ups, the textile industry, and small enterprises that under-employ potential GBV victims is a critical economic intervention that addresses the allures of economically motivated sex.

We can all be potential victims of Gender-based violence women, children, and adolescents as vulnerable segments must receive sex education, protective gear such as condoms, lubricants, reproductive health materials, and protection skills.

Tracking data of GBV to HIV/ cases in communities must be captured and effectively monitored.

A holistic policy review of oppressive draconian laws that were recently passed by parliament against key and priority populations must be rescinded with immediate effect.

Human rights framework strengthening, multi-sectoral and multilateral collaborative efforts, toll-free lines, and adding HIV protection measures among top priority health components.

Communities, civil society, and local councils must work together to establish safe shelters for effective evacuation and emergencies for the survivors and victims of sexual violence and gender-based violence for rehabilitation, psychosocial assistance, and a fresh impetus.

From Washington to Kyiv, Accra to Cairo, Kampala to Cape Town, Tamale to Nairobi every woman deserves respect.

'I would not like to witness the efforts against HIV/AIDS made by Dr.Robert Gallo, Luc Montagnier, Noerina Kaleeba, Kenneth Mugisha, Philip Bongole Lutaaya, Lydia Barugahare and institutions like PEPFAR, AIC, USAID, CDC, Daily Monitor among others going to waste due to neglect of Gender-based violence escalation as a hotspot for HIV persistence after 2030'

Addressing the underlying factors like abuse of alcohol, ignorance, drugs, and substance abuse, poverty, and cultural norms upon which gender-based violence thrives is key to HIV/AIDS Zero generation.

Robert Kigongo is a sustainable development analyst.

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