To end HIV, let’s invest in young women and girls

by Monica Geingos | First Lady of the Republic of Namibia
Saturday, 1 December 2018 10:00 GMT

A child carries a chair past an entrance to a makes shift shebeen at a township in Okahandja, Namibia, February 21, 2017. REUTERS/Siphiwe Sibeko

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Africa has come a long way, experiencing remarkable economic growth, but to reach our full potential as a continent we need genuine inclusion

Monica Geingos, First Lady of the Republic of Namibia.

The first time I met somebody with HIV was around the time my country became independent. Being infected with HIV in 1990 was a death sentence. That person was a close relative of mine, and died soon after. There was also a lot of fear and stigma, so nobody spoke about their HIV status. My mother, who was a nurse, was less afraid and treated AIDS patients early on.

Over the last decade, Namibia has halved its HIV incidence and has made great progress in preventing mothers from transmitting the virus to their babies. Namibians today can openly talk about HIV and sexual education, even at schools. These successes have been made possible thanks to Namibia’s commitment to invest more in the health of its people coupled with global solidarity and partnerships with multilateral agencies like the Global Fund.

But while HIV infections among the general population are declining across many countries in Africa, this is not the case among adolescent girls and young women who remain disproportionately affected by HIV. It is clear that we need to do more to break the shackles of inequality that are leaving our adolescent girls and young women way behind.

Africa has come a long way, experiencing remarkable economic growth, but to reach our full potential as a continent we need genuine inclusion. We can keep talking about HIV, but if we don’t address the complex socio-cultural norms stopping young women from fully exercising their sexual reproductive rights and having access to quality health care we will not make much headway.

The numbers speak of the size of the challenge. Every day, more than 1,000 teen girls and young women acquire HIV globally. In sub-Saharan Africa, 75 percent of new HIV infections among young people are among girls and women aged 15-24, and Namibia is one of the hardest-hit countries. Nevertheless, more men are dying from AIDS in Namibia because they are less likely to get tested and treated, but are spreading the disease through multiple sexual partners, in many cases to  younger women engaged in transactional sex.

In many many parts of Africa, women have no way of negotiating the choice or even the use of contraceptives with a partner. Similarly, there are women in relationships who have no option of refusing sex, nor the power to demand the use of a condom.

Achievement of equality between men and women is one of the most important prerequisites for global prosperity and the advancement of society. The denial of such equality in whatever form, perpetrates an injustice against one half of the world's population and promotes harmful and unhealthy attitudes and habits.

One way to win this battle is to invest vigorously in education for girls. Evidence shows that keeping girls in school not only raises a girl's standard of living and empowers her to be more independent, it also improves prevention from getting HIV. We also need to make sure young women and girls have access to quality health care and to sustained and relevant information about HIV.  As a mother of an adolescent girl, and as a First Lady, I can speak from experience. We need to learn how to listen, understand, relate and communicate to youth when it comes to difficult social issues such as relationships, sexuality and life choices – which can all be connected to HIV.

Through political will and global solidarity we will be able to accelerate access to quality health care for all and end the HIV epidemic. Namibia is committed to advancing towards that goal. In Namibia, government’s domestic spending today covers 65 percent of HIV funding needs, and by 2019 we will be purchasing 100 percent of life-prolonging AIDS drugs. This effort has allowed us to be on track to reach UNAIDS targets of 90-90-90 by 2020 (90 percent of H.I.V.-infected people having had an H.I.V. test; 90 percent of those who test positive having been prescribed drugs; and 90 percent of those prescribed drugs staying on them faithfully enough to have undetectable levels of the virus in their blood).

I am excited to have partners such as the Global Fund. The Global Fund is investing to improve the health of women and girls, by advancing gender equality and supporting programs that can build resilience and independence among young women and girls. Next year, we have a chance to renew this spirit of collaboration and solidarity, as the Global Fund holds its next replenishment conference to raise new funds and mobilize partners toward ending AIDS.

With sustained domestic and international investments in health and other programs that affect women's health, we can lay the foundation that can transform the lives of Africa's women and girls and reach important milestones in changing the course of the epidemic.