Handover of Nkurenkuru Health Centre and Nankudu ART Clinic Upgrades

Remarks by Ambassador Thomas F. Daughton for the handover of Nkurenkuru Health Centre and Nankudu ART Clinic Upgrades Nankudu District, Kavango West Region

Good morning! Early this year, the U.S. Government through the President’s Emergency Plan for AIDS Relief, or PEPFAR, committed itself to provide improved antiretroviral treatment clinic spaces for the communities served by the Nkurenkuru Health Centre and the Nankudu District Hospital.  Today, that commitment has been fulfilled.  Today is a celebration of what happens when a commitment between partners is made, action is taken, and tangible results appear in just a few months.  We’re here today not only to celebrate the completion of this improvement work, but also to show that we value the longstanding collaboration between the Namibian and American governments on work that improves the well being of the Namibian people.

Today is also a celebration of the hard work that has been put in by the team on site and by the teams at national and regional levels.  And, most importantly, today is a celebration of the better quality of care that will be available to more than 1,000 patients on ART at Nkurenkuru and to more than 800 patients from the local community at Nankudu.  It’s important to note that among those patients are many children, whose futures are being secured through antiretroviral treatment.  All of these patients are now able to access ART services in comfortable and conducive environments.

We have been working with the Ministry of Health and Social Services for a number of years now to make quality healthcare accessible for Namibians at the community level.  The reason is pretty simple: making healthcare accessible to communities saves patients time and money, increases the likelihood that they will access health services, and improves their quality of life.  That is why I came to Kavango West today:  to highlight how this kind of project to bring health services closer to people has an impact both on individuals’ lives, and through them, on Namibia’s drive to control the HIV/AIDS epidemic.

In Nkurenkuru, the U.S. Government invested about N$1.7 million.  And, in Nankudu, we spent about N$1.2 million to renovate the facility to make it more accessible and attractive for patients.  In both cases, our investment is about N$1,600 per person, and we hope those investments will have a big impact on the lives of the people of these communities.

You know, the American government has been working with the Namibian government to fight the HIV epidemic in this country for 14 years, and one thing that our experience has taught us is that, in order to achieve full control of the HIV epidemic, we have to pursue an intensive, site-by-site strategy brings health services close to where people live.  That’s because it needs to be convenient and inexpensive for people to access HIV testing and treatment.  For example, it only takes about 15 minutes to drive from Nkurenkuru to Nankudu, but on foot it takes the better part of a day.  So part of improving access is having more health facilities closer to communities.  Another part is providing facilities that people want to use.  When access to treatment involves having to sit in an overcrowded waiting room or having to travel long distances to collect their medications, patients end up dropping off their treatment, and then their virus isn’t controlled.  Because the burden of having to find the time, of having to find the transport, or of simply having to find the energy is, understandably, too much.

But when a patient is able to visit a local ART clinic — a clinic that has space for a patient to sit and wait in privacy away from other patients with different health needs — when a patient is able to collect medication from a local pharmacy, then burdens are removed, adherence to treatment improves, and that patient really does have an opportunity to live a long and healthy life.

I’m pleased to be able to say that the examples we will see today, of site-by-site support, are not just found here in Kavango West.  Through an agreement between the U.S. Centers for Disease Control and Prevention – we call it CDC – and the Ministry of Health and Social Services, the U.S. Government has provided 37 prefabricated structures at 29 sites in six regions.  If I had enough time, I would travel to all of those sites to celebrate the improvements that have come with these renovations.  These renovations demonstrate the combined commitment of our two governments to build a sustainable healthcare system in Namibia.  Through the renovations made at the 30 sites, we have together shown how, at a much lower cost, existing resources can be turned into functional and usable spaces for healthcare provision.

I want to thank all of the people involved for the hard work that has been put in to refurbishing these ART clinics.  I recognize that this was not just a one-size-fits-all plan, and that means a lot of work.  First there were individualized needs assessments, and then you used innovation to create practical working spaces. To all of the people involved in the planning, the procurement, the construction — and don’t forget the cleaning — I congratulate you on your vision and your dedication.  To the healthcare providers at these facilitiers, we hope that the improved spaces and reduced pressure will create a more conducive and productive environment for providing services.  It is just as important for healthcare providers to work in conducive facilities as it is for patients, because better working conditions mean reduced risk of burnout and better patient management.  Healthcare providers are clients of the system, too, and interventions to end the HIV epidemic must never forget that.  To the patients that will use these clinics, I hope that they serve you well on your healthcare journey.

It’s worth pointing out that the rate of new HIV infections in Nankudu is slightly higher than the national level – and that’s not good.  But these facilities offer hope.  And, with continued collaboration between the Namibian and American governments, I am confident that we can achieve the goal of testing everyone who is infected with HIV in this district.  When that is achieved, not only can they get on treatment to prevent them from getting sick or dying from AIDS, but they can also bring the virus in their bodies under control so that they are not able to transmit HIV to anyone else.

Fifteen years ago, people were dying from HIV.  Today, if a person is diagnosed early with HIV and is immediately started on antiretroviral therapy, he or she has every chance of living a long, healthy and normal life.  But to have that chance, that person has to stay on treatment.

Treatment adherence, as the doctors call it, is a key component to getting the HIV virus under control in a patient and in the country as a whole.  When a person has a virus that is fully controlled or has an undetectable viral load, that means the chance of transmitting HIV to an uninfected partner, or an unborn or new born baby is reduced almost to zero.  That’s what we are all working toward:  for every Namibian who is HIV-positive to know his or her status and get life-saving treatment and for that treatment to ensure that there are zero new infections.  And so, as we officially open these improved facilities today, we are not just cutting a ribbon, we are celebrating another important step towards Namibia becoming HIV-free.

Thank you.