John* plays quietly on the floor as his caregiver looks proudly on. Healthy and growing, John is the perfect example of a thriving 3-year-old. However, this was not always the case. John was infected with HIV at birth, and despite being put on the HIV treatment available at the time, the virus was not suppressed in his body. “Every time we visited the clinic for a check-up, I would cry” his caregiver explains. “I was giving him his medicine, but it wasn’t working. I didn’t know what I was doing wrong.” Some of the older HIV medicines are less pleasant to take, as well as being less effective than newer medicines at controlling HIV, meaning that even with medication, children are not able to fight and suppress the virus in their body. The testimony from John’s caregiver is a reminder of the pain parents and caregivers experience, when despite doing their best, they cannot keep their children healthy.
Fortunately, in July 2021, the Ministry of Health and Social Services introduced new HIV medicines for young children. The medicines contain a product called dolutegravir (also known as “DTG”), which studies show is more effective at treating HIV, less likely to cause side effects, easier to take, and better tasting.
“The effect was almost instantaneous,” says John’s caregiver. “By taking this medicine, John quickly got the virus under control. Now when I visit the clinic, I am singing and dancing.”
John’s health rapidly improved after starting his DTG medication, and his success story is one of over 11,700 across Namibia. In just one year, the Ministry of Health and Social Services has ensured that all eligible HIV-positive children and adolescents in the country have access to this medicine.
The introduction of this new medicine to Namibia has been achieved through a collaborative effort between the Ministry of Health and Social Services and partners such as the U.S. Centers for Disease Control and Prevention (CDC) and the United States Agency for International Development (USAID), through funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The United States Government has partnered with the Ministry of Health and Social Services throughout the entire process, from the initial procurement of the medicines to the development of educational materials and training, while also including intensive technical assistance during the rollout to the public.
“Providing DTG-based medicines for children and adolescents living with HIV is life-changing. Children deserve the best chance to live long, health and happy lives, and through support from the U.S. Government, we have done our part to help achieve this for a critical group of young people in Namibia,” says CDC Namibia Country Director, Dr. Brian Baker.
As we move through 2023, there are still challenges to address in the treatment and care of children living with HIV. Collaborative goals between the Ministry of Health and Social Services and the U.S. Government to strengthen HIV care and treatment for children and adolescents in 2023 include: training more healthcare providers on how to explain to children why they take medicine and how important it is to take each day; continued support for older HIV-positive adolescents to take a leadership role to support other HIV positive children and adolescents; and starting support groups for parents and caregivers of children and adolescents living with HIV to better provide them with the support they need.
“Providing child-friendly healthcare means providing care in the way that fits their needs. Children and adolescents living with HIV need to take medicine for the rest of their lives. By keeping the virus undetectable in their body, they can remain healthy, and they can’t pass the virus on to other people. When we optimize their treatment regimen during childhood, we help to set up the next generation of adults, leaders, parents, friends, and family, for the best possible success,” concludes Dr. Baker.
*Name has been changed