HIV Prevention and Sexual and Reproductive Health and Rights for Adolescent Girls and Young Women: Eastern and Southern Africa Regional Consultation

1-3 February 2017, Windhoek, Namibia

Director of Ceremonies, Dr. Andreas Mwoombola, Permanent Secretary at the Ministry of Health and Social Services;

Honorable Dr. Bernard Haufiku, Minister of Health and Social Services;

Prof. Sheila Tlou, UNAIDS Regional Representative;

Mr. Desta Tiruneh, acting WHO Representative to Namibia;

Esteemed colleagues and partners from the Namibian government;

Delegates from Eastern and Southern Africa;

Distinguished guests; Members of the media; Ladies and gentlemen:

Good afternoon!  If it’s not too late, given that we’re already into February, let me wish you all a happy new year and, for those of you who have traveled here from outside Namibia, a warm welcome.  It is a real pleasure to be here today at the official opening of this regional consultation on HIV Prevention and Sexual and Reproductive Health and Rights for Adolescent Girls and Young Women.   The people in this room today have come from all over eastern and southern Africa with one common goal:  the elimination of HIV and AIDS, especially among young people.

In my view, there is no better place to hold this consultation than here in Namibia, where the government has shown exemplary leadership in reaching out to its young citizens about the risks of HIV.

That leadership has come right from the top, from the honorable Minister of Health and Social Services, Dr. Bernard Haufiku.  I want to commend Dr. Haufiku for his firm commitment to achieving HIV epidemic control in Namibia. Under his leadership, remarkable progress has been made, and much of what has been achieved was reported at the National AIDS Conference held in Swakopmund at the end of November.

Crucially, Namibia has made great strides in improving access to, and quality of treatment for, people living with the virus by decentralizing antiretroviral therapy services.  The latest estimate is that 76% of people living with HIV in Namibia are now on antiretroviral treatment.  Even more significantly, almost every HIV-positive pregnant woman in this country receives antiretroviral treatment.

Also at the AIDS conference, the Ministry of Health and Social Services launched updated treatment guidance that includes both the “Treat All” approach and the use of Pre-Exposure Prophylaxis, or PrEP as it is commonly known.  Both of those – Treat All and PrEP – will significantly expand HIV treatment for Namibians and avert new infections in this country.

As the participants here today know, in much of sub-Saharan Africa, young people are highly vulnerable to HIV infection.  For both economic and cultural reasons, adolescent girls and young women not infrequently acquire HIV from men who are much older, and many remain unaware of their HIV-positive status for years.

Every year, 390,000 adolescent girls and young women are being infected with HIV.  Worse, girls account for 75% of new HIV infections each year among adolescents in Sub-Saharan Africa[1].  And HIV testing and treatment coverage continues to be unacceptably low among these groups.  In this region, only 40 to 50% – less than half – of young people between the ages of 15 and 24 know their HIV status, with the result that too few of them are on treatment[2].

Reaching the affected adolescent girls and young women as well as the affected young men remains a challenge in Namibia and across the region.  But the reality is simple:  if we want to break the propagation cycle of the virus, we must address the health needs of adolescents, girls and women collectively.

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is currently funding an array of programs to accelerate the provision of HIV services throughout Namibia.  And this year, in line with our Country Operational Plan that begins in October, PEPFAR will program additional funds directly for HIV prevention and treatment for adolescent girls and young women in Namibia.

These additional resources will support evidence-based interventions that are more directly and immediately linked to reducing HIV acquisition by adolescent girls and young women.  These interventions will include as post-violence care, optimized HIV testing services, PrEP, and effective, youth-friendly sexual and reproductive health services.

As PEPFAR works to support the Namibian government and civil society in reaching young people, we want to draw experiences from efforts in other countries.  That’s why, last year, we supported a team of experts from the Ministry of Health and Social Services and civil society groups to travel to South Africa to learn from some of the best practices implemented there to avert new HIV infections in adolescents and young women. The team saw for themselves how the South African government has included the preventative use of antiretroviral drugs as one method to avert HIV infection among young people, especially those who are at substantial risk of acquiring the virus.  

In Namibia, pre-exposure prophylaxis – PrEP – offers an opportunity to prevent HIV infection among adolescents and young women who are at substantial risk of acquiring HIV.  It also provides an additional tool for those who live in relationships where only one partner is positive.

This consultation brings all of you together to chart ways, explore innovations, and discuss best practices and strategies to reach adolescent girls and young women, who form a crucial pillar of the future of this and every other country.  

What is it that we need?  We need to find ways to reach adolescent girls and young women with evidence-based prevention programs.  We need to ensure that young girls remain HIV-negative through a holistic approach that includes helping them stay in school, educating them on the risks of HIV and how it is transmitted, and ultimately, empowering young women to make safe choices. For those who become infected with HIV, we need to have programs that can help identify them early on by providing optimized testing and treatment services that are accessible, safe and acceptable to them.  

Adolescents and young women have to be at the center of any HIV prevention program.  Addressing them is an essential component for achieving HIV epidemic control and sustainably maintaining the gains that we have worked so hard to achieve.  This includes integrating services in the context of girls’ sexual and reproductive health and rights.

We have strong evidence and supportive data, and we need to ensure that we are able to reach adolescent girls and young women.  The time to act is now.  Responding to this challenge requires innovation and creativity.  I am convinced that all of you here today can chart a route that will carry us all to success.

And it will take the support of us all:  governments, civil society, PEPFAR, and our global partners, the World Health Organization and UNAIDS, with whom we work very closely and will continue to work very closely both at the country level and worldwide.

It is through this cooperation and knowledge-sharing that we can deliver time-sensitive and high-quality, evidence-based guidance to move forward rapidly to achieve epidemic control and an AIDS free generation.

Thank you.