Guidelines for Anti-retroviral Therapy, First Edition, April 2003 - Republic of Namibia
(2003; 48 pages)


For many years, the Ministry of Health and Social Services has informed the public of the rising numbers of persons with HIV and the major impact the pandemic will have on the Namibian society. The Ministry has encouraged all Namibians to come for voluntary counselling and testing and encouraged persons living with HIV to live positively.

Although persons with HIV can live fully productive lives, this becomes increasingly difficult once the immune system is severely affected by HIV. With increased availability of antiretroviral (ARV) drugs, new options to reduce the impact of HIV and AIDS have become available: prevention of mother to child transmission (PMTCT), treatment to prevent accidental infection of health workers and rape survivors (also called post-exposure prophylaxis, or PEP) and highly active antiretroviral treatment (or HAART) for persons with advanced HIV infection.

Increasing numbers of Namibians are gaining access to ARV therapy, in part because the Namibian Government can cover the cost of ARV therapy for eligible civil servants through Government medical aid. Government has also recently allocated funds to purchase drugs, and our partners through bilateral assistance and the Global Fund to Fight AIDS, Tuberculosis, and Malaria are also helping Namibia to increase drug access through the public sector. In order to make efficient use of limited resources and to ensure optimal therapy, the Ministry has developed these "National Guidelines for Anti-Retroviral Therapy". These guidelines are the result of a consultative process, whereby clinical specialist and general practitioners have been involved from the private and public sector in different parts of the country. These guidelines therefore constitute the basis for ARV therapy in Namibia.

These guidelines complement the existing guidelines from the Ministry of Health and Social Services on "Clinical Management of HIV and AIDS", and "Counselling and the Policy on HIV/AIDS Confidentiality, Notification, Reporting and Surveillance". Moreover, the guidelines will be further complemented by specific guidelines on prevention of mother to child transmission and post exposure prophylaxis that are currently under preparation.

HAART is not a cure. In order to be effective, the patient should take all the prescribed drugs every day at the right time. It is a life-long commitment and requires continuous support from within the household, extended family, from friends and the community. If the therapy is taken correctly, the number of the viruses in the blood declines dramatically. Even if the virus cannot be detected in the blood, the virus can still persist in body fluids and HIV transmission from a person on HAART remains possible. Health care workers should always continue to exercise universal precautions, and the patients themselves should receive regular counselling and support to practice safer sex and to live positively with HIV.

To make effective antiretroviral therapy accessible for as many Namibians as possible, partnerships will have to be built with committed community groups such as organised groups of persons living with HIV, private companies, neighbourhood committees and home-based care initiatives.

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