Namibia reached a milestone in eradicatingmother-to-child disease transmission

Niël Terblanché

Namibia has an unprecedented opportunity to eliminate new HIV, Congenital Syphilis and Hepatitis B infections among newborn babies and children.

The country has achieved the 95-95-95 targets set by the World Health Organisation (WHO) and the government is fully committed to the goal of Zero New HIV Infections while continuing to invest in the HIV and AIDS response

According to Ben Nangombe, the Executive Director of the Ministry of Health and Social Services, investment is needed to sustain the tremendous progress the country has made in scaling up HIV service to ensure easy access to comprehensive, high-quality treatment and prevention services by all, including Prevention of Mother-to-Child Transmission of HIV, Syphilis and Hepatitis B Virus.

Nangombe officially opened a meeting between the health ministry and the Regional Validation Committee of the WHO in Windhoek that will evaluate Namibia’s progress with the Path To Elimination (PTE) of Mother-To-Child-Transmission (EMTCT) of serious illnesses and said the country is on course to completely eliminate Mother-to-Child Transmission of HIV, Syphilis and HBV by 2024.

According to Nangombe, the EMTCT programme was introduced as a pilot in 2002 at Katutura Intermediate Hospital and two other hospitals before it was rolled out at all health facilities in the country.

He said the goal of the programme is to eliminate mother-to-child transmission of illnesses to below two percent by 2028.

He added that to reach the goal, interventions such as the primary prevention of HIV among reproductive age groups, the prevention of unintended pregnancies among women living with HIV, the prevention of HIV transmission from HIV-infected women to their infants and the provision of comprehensive care to mothers living with HIV, their children and families.

“The government’s commitment coupled with technical and financial support from partners, helped to rapidly scale up EMTCT services nationwide. The support included guideline development, training of health workers, procurement of equipment, Ant-Retro Virals (ARV) and supplies, capacity building of laboratory services, supporting community-based interventions as well as recruitment of key staff for HIV response and infrastructure development where it was deemed necessary,” he said.

He said that over the years, Namibia has made significant strides and indicators are that Namibia will be one of the next countries in Africa to be certified for being on the path to triple elimination of Mother-to-Child Transmission of the three infections.

“Namibia launched its national roadmap for elimination of HIV and Syphilis in 2020 and at the same time established a National Validation Committee (NVC) with multisectoral members under the leadership of the Ministry. The roadmap outlines priority interventions that Namibia is and will focus on in order to steadily move towards becoming certified as having achieved the Gold Tier Status of only 250 cases per 100 000 live births as per the World Health Organization’s path to elimination targets. Despite the Covid-19 situation between 2020 and 2022, the country continues to ensure that EMTCT services and the gains made towards the elimination of the three diseases were not completely wiped out,” he said.

He said the NVC with the support of the health ministry and partners conducted a pre-validation assessment in a consultative approach using standardized tools recommended by the WHO-led Global Validation Committee (GVAC).

“The NVC, technical experts and stakeholders played major roles and contributed in the finalization of the National Validation Report that was submitted to the Regional Validation Committee on 30 June 2023 through the WHO Country Office,” he said.

The national triple-validation report highlights that Namibia has attained almost universal testing coverage for HIV and syphilis in Antenatal Care settings and almost all people who test positive for HIV and Syphilis receive treatment. The programme data also indicates that Namibia is doing well with HBV antenatal testing and antiviral prophylaxis coverage as well as HBV birth dose for infants

Nangombe said that according to spectrum estimates, the overall Mother-to-Child Transmission rate of HIV was 4.02 percent in 2020, 4.41 percent in 2021 and 4.14 percent in 2022. This translates to a Mother-to-Child Transmission case rate of 481 per 100 000 live births in 2020, 486 in 2021 and 486 in 2022.

“These achievements have been made through the implementation of evidence-based interventions in line with global and national standards coupled with a strong network of laboratory services, and functional and reliable data management systems. In addition, the achievements have been made with greater and meaningful engagement of communities, people living with HIV and respect for gender equality and human rights,” Nangombe reiterated.

He added that by considering that the journey to triple elimination is a continuous process, the report also acted as a lens for identifying existing bottlenecks for which health authorities should continuously find lasting solutions.

“To this extent, the government through the health ministry and other government sectors will continue to strategically engage with development partners, non-governmental organizations and the private sector to ensure equitable elimination of Mother-to-Child Transmission service provision and sustainability at all levels,” he said.

He said the meeting with the RVC is a great opportunity for the NVC, the MoHSS and it’s implementing partners to share current evidence-based progress towards triple elimination with the RVC.

Dr Mary Brantuo, the Officer in Charge of the WHO during the opening of the meeting said that the Regional Validation Committee is a standing committee of expert members, from UN agencies – UNICEF, UNAIDS, WHO, development partners – US CDC, ministries of health, civil society, and academia.

According to Dr Brantuo, the objectives of the regional validation PTE process are to review the National Validation Report that was submitted by the Namibia National Validation Secretariat (NVS), to develop the Regional Validation report, which will provide an assessment of Namibia’s progress in meeting the Path to Elimination validation criteria and processes for the elimination of mother-to-child transmission (EMTCT) of the three diseases, Triple Elimination and to provide specific recommendations to the Regional Validation Secretariat (RVS) on whether Namibia has successfully met the Path to EMTCT validation criteria and can be officially recommended for review at the global level by the Global Validation Advisory Committee (GVAC).

She pointed out that to date, only one high-burden country and one in the African Region have successfully applied for and been validated as being on the Path to Elimination of mother-to-child transmission of HIV only.

“Namibia is the first high-burden country in the Region to apply for triple elimination validation. This is a huge achievement, and we commend you on this effort,” she said.

She stated that Namibia’s exceptional political, administrative, and financial leadership and support plus the strong in-country partnership are largely responsible for the significant progress made toward EMTCT for these three infections.

“The UN in Namibia, will continue to work with you to see the full realisation of the aspiration for the people of Namibia, and more babies born free of HIV, syphilis, and hepatitis B,” she exclaimed.

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