Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date.
International Federation of Red Cross and Red Cresent Societies - 17 March 2004
Denis McClean
The Caprivi Strip, a remote sliver of land bordered by Angola, Zambia and Botswana, lies 1,600 km by road from the capital, Windhoek, and the local adult population is registering HIV infection rates of 43 per cent.
Stigma and discrimination against people living with HIV/AIDS, allied to local customs such as polygamy, play a significant part in fuelling the epidemic.
Nonetheless, it is here that the Namibia Red Cross and the Ministry of Health have decided to deliver on a commitment to close the treatment gap by putting at least 750 people on ART in the next twelve months. Funding is being provided through the pharmaceuticals giant, Bristol-Myers Squibb's 'Secure the Future' initiative.
The local hospital in the regional capital, Katima-Mulilo, serves a population of 72,000, but currently lacks even the resources to do blood-testing and all samples have to be sent by road to Windhoek, a journey which often results in vehicles breaking down and blood samples being spoilt.
"The challenges are great but since we started in December we now have 16 people on ART in their own homes in the Caprivi Strip where they are visited and supported by local Red Cross volunteers who have been trained as counsellors," explains Namibia Red Cross secretary general, Razia Essack-Kauaria.
The Red Cross role is to manage the voluntary testing and counselling centre where people come and give blood samples and then they are referred to the Ministry for Health for diagnosis and ART. Once a person is on treatment, the Red Cross helps to ensure all the necessary family and compliance support as well as food parcels where required.
"In an area with high levels of stigma and discrimination, the fact that you have 16 people on treatment is a major victory. Recently a man with four wives came for testing and once he tested positive he became very concerned for his wives and said he would bring them all for testing," Essack-Kauaria says.
"In a place where infection rates are so high, the issue of confidentiality is very important. Nobody is willing to come out and say 'I'm HIV-positive'," she says.
But she remains hopeful that once people realise they can access treatment, this will reduce the aversion to being tested, which is fuelled by stigma and discrimination.
More Namibia Red Cross volunteers are completing their training this week in counselling and providing home-based care.
The Namibian Red Cross representative is in Geneva this week to attend her first meeting of the Board of the Global Fund to Fight HIV/AIDS, Malaria and TB.
Essack-Kauaria says that organisations such as hers from developing countries have valuable skills, knowledge and experience in advocating on, and responding to, the threat of the world's three deadliest diseases.
It is estimated that the Global Fund û the main funding mechanism for reaching the target of three million on ART by 2005 û will need to raise over US$ 5 billion in the next two years.
To date, some US$ 300 million has actually been disbursed from US$1.4 billion committed over the last two years.
Today, 3 million people die every year from AIDS. There are just 400,000 people on ART out of 6 million people in need of access to this life-prolonging treatment. Only 100,000 people in Africa have access to ART including the fortunate 16 in Namibia's Caprivi Strip.
Essack-Kauaria sums up the human dimension of this on-going tragedy for mankind: "Everybody wants their life saved. Everybody wants to live a day longer to be a parent."
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