New Era journalist, Alvine Kapitako, spoke to the Executive Director of the Namibia Network of AIDS Services Organisations (NANASO), Sandi Tjaronda, about the organisation as well as HIV/AIDS in the country.
New Era (NE): What are the challenges facing NANASO?
Sandi Tjaronda (ST): “The biggest challenge facing the network is the issue of funding. We have a situation of the number of donors declining in the country, which is causing a huge scare and could jeopardise our programmes and we may not be able to achieve all that we want to achieve in terms of moving forward.”
NE: Do you think as a country with one of the highest HIV prevalence rates in the world Namibia can survive with minimal or no donor funding?
ST: “All the drugs, ARV’s are coming from state coffers, I think that is a commendable effort. Government taking ownership of the rollout of HIV drugs clearly shows that we can actually manage the disease locally. We can move away from dependency on donor funding and external donor funding to deploy our own resources and mobilise our own efforts.”
NE: What is NANASO doing to reach minority groups with its HIV/AIDS awareness messages?
ST: “HIV/AIDS is a minority disease. It is a disease that creates a constituency of minority groups, because those that are infected are a minority and they become very susceptible to stigma and discrimination. NANASO is built on defending minority rights and advocating for those rights and interests. We have programmes that are targeting every Namibian including those groups. For example, the situation around the Ovahimba – the information we have obviously is that the Ovahimba are not necessarily the most affected group of our society, and the San. It could be different now with the interaction with the outside world, but the Ovahimba and the San had within themselves strong value systems that always protected them even with the advent of HIV. Kunene has for some time been the region with the lowest (HIV) prevalence rate and that is something to do with their cultures, their location, how they behave and what they do. The San are also the same. They are not one of the vulnerable groups although they are vulnerable in terms of their population and their numbers, but in terms of their strength in the response – they have been one of the strongest. But we have other minority groups, what we call the key population, such as commercial sex workers, men who have sex with men, for whom we constantly initiate programmes to ensure that they are protected in the response.”
NE: What is NANASO doing to make sure that the HIV message gets to the most remote areas in the country?
ST: “NANASO is active across the country. We are making sure that our members, wherever they are, are communicating the messages to the constituencies where they operate. We also engage in public campaigns, we participate in expos and trade fairs where we convey our messages to those who visit those platforms. Our outreach programmes are there to reach them in the languages that they speak, with people that they know. Within all the programmes that we have, including the Global Fund programme, where we are a principal recipient, we are reaching out to all the areas in all the corners of the country trying to convey the message of awareness, prevention, impact mitigation, treatment, care and support and so forth.”
NE: Namibia has made considerable strides in fighting HIV/AIDS. The prevalence rate is not as high as it was in 2000 when HIV/AIDS was seen as a huge problem. The majority of HIV positive Namibians have access to the life saving anti-retroviral drugs. We are now aiming to eliminate mother to child transmission of HIV and many other challenges. Would you say HIV/AIDS is still a problem in Namibia?
ST: “At 18.2 percent (prevalence rate in the general population) it is a serious concern. It is a serious problem and is still one of the most dreadful diseases in the country. We have a small population and 18.2 percent is a very significant number and given the fact that even the sample size that we are using is just women who go for antenatal care services. It’s not even giving us the total picture, so we might be dealing with a much bigger problem than we think. The challenge is that many of us are HIV/AIDS fatigued. We are tired of hearing about HIV. For 23 years we have been talking about HIV and everybody thinks ‘but why is this thing not coming to an end?’ So we are tired, there is fatigue and it’s understandable. So, we need to come up with innovative approaches that can actually start to appeal to people. So, yes to your question, it is a huge concern.”
NE: Why do we still have cases of people contracting HIV on a daily basis, despite efforts by the government and civil society to combat the pandemic?
ST: (Sighs) “HIV is a behaviour thing, it has to do with our behaviour. For 23 years we have invested in trying to change the behaviour of people, communicating messages that are geared at behaviour change, but people have got their own choices to make. They can choose to change their behaviour, they can choose to continue doing whatever they are doing for their own reasons. So, the (HIV) infection rate is still high, particularly among young people, according to the sentinel survey that was released in 2012. That’s a worrisome thing, because if you have the youth being infected on a daily basis you have a future that is very, very bleak since our young people are our future and if we lose our young people we don’t have a future. We don’t have a workforce; we don’t have teachers; we don’t have doctors and we don’t have engineers. One question we have to ask is ‘why are the youth highly affected by this?’ And you can think of so many things, but one thing that we have and are still fighting for is access to information and access to health facilities. I’m glad that we have made efforts to make sure that there are adolescent friendly services available for them. Funding is also a problem, but we need to look at how we invest for results.”
NE: We recently read that a huge consignment of Cool Ryder condoms arrived in the country from India after being absent from the market for quite some time. Would sourcing condoms locally solve this problem?
ST: “It is all about the prices of commodities. It is always a disadvantage to have a small population. But the arrival of the Cool Ryder is a welcome gesture, because that product appeals to the youth.”
NE: ‘An HIV-free generation is possible’ is a common phrase or slogan. Do you agree?
ST: “It is possible but it will take double our current efforts. It will mean for us to wake up from the slumber of denial; it will mean we have to wake up from stigma and discrimination; it will mean we have to wake up from thinking that we have arrived when we have not arrived – deceiving ourselves. We have not gotten there yet. We are still far away. If an 18.2 percent HIV prevalence rate doesn’t scare you … well it scares me. If we go into the details of understanding this virus we would then be able to talk about the possibility of an AIDS-free generation.
By Alvine Kapitako