Handover of Community-Based ART (C-BART) Clinic to Oupili Community

Remarks by U.S. Ambassador Thomas F. Daughton at the handover of Community-Based ART (C-BART) Clinic to Oupili Community Okongo District, Ohangwena Region

Good morning!  During the last couple years, in my role as U.S. Ambassador I have had the opportunity to visit many places in this beautiful country, but it is truly a pleasure for me to be here today to help celebrate the leadership this community has demonstrated.  Oupili community is a trendsetter – not only within Namibia, but on a global level as well – and you all deserve congratulations!

The Okongo District’s community health leaders have been providing quality, community-based treatment to their HIV patients since 2007.  When you started this program almost 10 years ago, there were no guidelines about how to help people living with HIV in rural areas.  To survive, HIV-positive people need antiretroviral therapy, or ART, and your approach was simple: offer the best care to your community in the most direct way.  It was an elegant and effective solution.  Knowing that your patients were traveling long distances and at high cost just to get their life-saving ART, you opened community-based medicine points.  You made it much easier for people living with HIV to get their medicine.

You were smart enough to see years ago that we have to reduce the time and cost ART patients spend traveling to a clinic to get their lifesaving drugs.  But you did more than that:  you also helped to reduce the stigma of being HIV-positive.  The result is clear.  People living with HIV and AIDS in Okongo live longer and have a better quality of life.  I am here today to recognize and congratulate you for your success in Okongo District.

By choosing to dedicate an area where a traditional home could be used to deliver HIV/AIDS services, the Okongo District and your health care providers were pioneers in treating the people within your community who are living with HIV.  And Namibia is now adopting this model as a national standard to be replicated in other regions that face challenges similar to yours.

But more than that, the approach used here is now seen by the international health community as a model for providing critical health services.  The World Health Organization recognizes the need around the world for this kind of patient-centered and community-based method of HIV treatment, and now recommends that countries use an approach similar to what you have developed here in Okongo.  This concept was also a major focus of Namibia’s first-ever national conference on HIV and AIDS held two weeks ago in Swakopmund.  And a few days later, it was also a major theme of World AIDS Day.

With the Ohangwena Region leading the way, more regions will soon be following your great example.  Because the evidence demonstrates that the good work you are doing has made significant impact, the U.S. government is supporting other regions – like Khomas, Zambezi, Omusati, Oshana, Kavango East, and Kavango West – to implement similar models of care. This is all thanks to the Okongo District, because you came up with a simple but very innovative way of providing ART.

As you all know, staying on ART is key to ensuring that the therapy works and that the HIV virus stays under control.  When the virus is under control – or as people here say, when the virus is “sleeping” – patients on treatment are less infectious and their HIV is much harder to pass to someone else.  That’s why this model of care is a very important part of Namibia’s goal to control the HIV epidemic by 2020.

That’s why I am here today.  My government wants to help support the model of care you all have developed by converting the traditional huts into a modern medical facility.  This accomplishment is your work, and we want you to be proud of it.  So the U.S. government has spent N$5.2 million (US$372,000) to set up eight new clinics for community-based ART, or C-BART, in Okongo District.  The clinic we are officially handing over to you today is one of them.

With a C-BART clinic brought into the Oupili community, a wider range of health services will be available practically at your doorsteps.  Even HIV testing will be provided locally.  That means everybody should be able to know their HIV status and people who test positive can be started on treatment immediately.

Testing and treatment are absolutely crucial to controlling HIV.  We all know that, right?  But did you know that twice as many Namibian women as Namibian men go and get tested for HIV?  Why is that?  We say that Namibia is the land of the brave, but that statistic makes me think that Namibia is the land of the brave women!

So come on, Namibian men!  We can’t provide ART if we don’t know who needs it, so more Namibian men need to get tested.  My good friend the Minister of Health set the right example for Namibian men by getting tested earlier this month at the National AIDS Conference in Swakop.  Other men need to follow his lead, and Okongo’s community approach and these clinics make getting tested and treated easier.  So you brave Namibian women, please encourage the men in your lives to get tested!

When we talk about control of the HIV epidemic, we talk in terms of achieving the UNAIDS 90-90-90 targets by 2020.  That means 90% of all Namibians living with HIV get tested and know their status, and 90% of the people who are diagnosed positive receive anti-retroviral treatment, and 90% of the people on treatment live healthy lives with a suppressed – or “sleeping” – viral load.

One of the most remarkable facts about Oupili is how you’re doing on the third 90.  Did you know that the HIV virus is “sleeping” or under control in about 97% of people on treatment living in Oupili?  If you have done that well with the facilities you have, you should do even better with a modern clinic and all the required equipment.

I want to encourage Okongo District to continue the great work that you have started.  Make use of and care for these clinics so that more people are able to get testing and treatment in the future.  And let me commend the traditional and community leaders of this community for making land available to help in the fight against HIV.  I also want to acknowledge the religious leaders for their involvement in spreading the word about HIV care and the non-discriminatory messages about people living with HIV.  This facility will only be used to its maximum capacity when all the people in your community feel free of discrimination when they come to this site for care. The goal of HIV control in Namibia is within reach.  Let’s all help in making sure that no Namibian is left behind, and that includes Namibians who are HIV-positive.  Together we can prevent and treat HIV, and together we can end AIDS in Namibia.  Thank you.