Government Commitment & Advocacy

• President Joseph Nyumah Boakai reaffirmed his administration's commitment to supporting people living with HIV, emphasizing the importance of implementing the Safeguard Policy Exit Roadmap recommendations to the Global Fund by December 2024 to regain confidence and support and pledged timely and necessary assistance to combat HIV.

Impact of Foreign Aid Withdrawal & Mitigation Efforts

• The Ministry of Finance and Development Planning (MFDP) assessed the impact of foreign aid withdrawal and is working on an impact mitigation plan, including prioritization strategies.
• The Ministry of Health (MOH) allocated $300,000 for commodity distribution to minimize disruptions after support from the World Food Programme was suspended. MOH utilized its own resources to prevent service interruptions, assigning staff under its payroll for HIV services to ensure integration and sustainability.

Documented Impact on Services

• FHI360 (USAID-funded): Experienced a suspension but later received a waiver, allowing 26 facilities across four counties to resume case finding, PrEP for key pregnant and breastfeeding mothers, prevention, and referral services. However, prevention services for key populations remain excluded from the waiver.
• JHIEPGO & Global Fund-Supported KP Programmes: Community PrEP and above-site support, previously suspended, resumed two weeks ago. Human rights, key and vulnerable populations US-funded (FHI) key populations programmes remain ceased, with seven implementing partners canceled, causing significant gaps in HIV prevention services and case finding for key populations.

LGBTIQ+ Context & Rising Tensions

• The introduction of an anti-LGBTIQ+ bill on July 17, 2024, proposing life imprisonment for homosexuality, has created an environment in which it is difficult to deliver HIV testing, prevention and treatment services. The bill, sponsored by Hon. Johnson S. N. Williams, has fueled public hostility and increased risks for LGBTIQ+ individuals.
• A crisis within the Liberia Annual Conference of the United Methodist Church has further exacerbated anti-LGBTIQ+ sentiments. LGBTIQ+ communities have been sharing PrEP amongst themselves as they await the resumption of services.

Immediate Risks and Disruptions

• Termination of CSO Funding: Civil Society Organizations (CSOs) received termination letters on 27 February, leading to significant disruptions in HIV services.
• Service Disruptions: The closure of drop-in centers for key populations has disrupted HIV testing, treatment, care, and support services. There are challenges in referring clients to government facilities, as service providers are no longer working, and there has been no proper handover of client files.

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Immediate Risks and Disruptions

• Termination of CSO Funding: Civil Society Organizations (CSOs) received termination letters on 27 February, leading to significant disruptions in HIV services.
• Service Disruptions: The closure of drop-in centers for key populations has disrupted HIV testing, treatment, care, and support services. There are challenges in referring clients to government facilities, as service providers are no longer working, and there has been no proper handover of client files.
• Confusion Among Clients: The lack of reliable information and guidance has led to confusion and reluctance among clients to access services at other health facilities.

Politically Relevant Updates

• Government Response: The Ministry of Health has assured clients of continued access to ART services and encouraged CSOs to refer clients to government facilities. A task team, including the Ministry of Health, NAHPA, CSOs, and UN agencies (represented by UNAIDS), has been established to monitor the impact of the stop work order.
• EU Budget Cuts: While the EU ambassador confirmed drastic budget cuts in development financing, they pledged to fulfill their HIV commitments up to 2027. However, these funds will not bridge the gap left by the US Governement funding cuts.

Community Impacts

• Civil Society Resilience: Despite the challenges, CSOs have shown resilience by conducting rapid surveys to assess the impact of the stop work order. They are part of a multi-stakeholder task team and are actively participating in platforms facilitated by UNAIDS to discuss implications and share updates.
• UN Support: UNAIDS has been proactive in convening meetings with CSOs and facilitating discussions on the way forward. The UN country team and JUTA have been collectively discussing the implications, although there is still limited information on the next steps.

For years, Namibia’s HIV response has been supported by US funding, particularly through the United States President's Emergency Plan for AIDS Relief (PEPFAR). These programs have provided lifesaving drugs for HIV treatment, prevention services, and essential socio-economic empowerment initiatives, especially for adolescent girls and young women and the most marginalized and at-risk groups. 

However, given recent decisions by the U.S. to freeze and cut foreign assistance, Namibians struggling to fill the funding gaps. An emergency humanitarian waiver issued by the U.S. Government allowed for funding to flow to some projects and organisations (government and non-governmental) – but as the funds were not transferred into their accounts, they faced with serious cash-flow challenges and were at risk\ of contravening the Labour laws of the country.

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A long-standing partnership threatened

For years, Namibia’s HIV response has been supported by US funding, particularly through the United States President's Emergency Plan for AIDS Relief (PEPFAR). These programmes have provided lifesaving drugs for HIV treatment, prevention services, and essential socio-economic empowerment initiatives, especially for adolescent girls and young women and the most marginalized and at-risk groups. 

However, given the recent decisions by the US to freeze and cut foreign assistance, Namibians are struggling to fill the funding gaps. An emergency humanitarian waiver issued by the US Government allowed for funding to flow to some projects and organisations (government and non-governmental) – but as the funds were not transferred into their accounts, they are faced with serious cash-flow challenges and were at risk of contravening the labour laws of the country.

The US funding freeze has had a particularly devastating impact on community groups supporting the most vulnerable populations. In Katutura, for example, adolescent mothers who were benefiting from HIV prevention and socio-economic empowerment programmes saw their support vanish overnight.  “For the past year, these adolescent girls and young mothers have received psychosocial support, life-skills education and socioeconomic empowerment, but all these abruptly stopped, and their livelihoods are at risk,” said a representative of Lidar Community Foundation, a youth empowerment programme for orphaned and vulnerable girls in Katutra-Central, Windhoek. The loss of these critical services jeopardizes not only health outcomes but the livelihoods of some of Namibia’s most marginalized individuals.

A fragile civil society left to cope

Namibia’s civil society had long been reliant on external funding, with the US and the Global Fund being major contributors of the civil society-led HIV programmes. The US funding freeze has left civil society organizations working on HIV prevention, human rights and youth empowerment issues in a precarious position, unable to provide essential services and continue operations, forcing them to lay off their staff, scale back their operations, or even completely close their programmes.  

This situation is overwhelmingly affecting the most vulnerable and marginalized groups in Namibian society. Key populations—such as transgender people, sex workers, and people living with HIV—were already facing discrimination in accessing essential services. With the end of the US support, these groups are now at an even greater disadvantage. “This is such an emotional time,” said Kholi Buthelezi of the Sisonke National Sex Workers Movement in South Africa. “It triggers memories from that pre-ART times in the HIV era, when all we had was hope but no concrete resources to act on the challenges."

Young women, particularly adolescent girls, are another demographic severely affected by the US funding freeze. Many had been participating in HIV prevention programmes or socio-economic initiatives aimed at empowering them. These cuts have halted progress, leaving them more vulnerable to HIV and other socio-economic challenges.

The need for collective action

A meeting co-hosted by UNAIDS on 7 February to review the implications and impact of the U.S. funding freeze, highlighted the need for collective action to help Namibia’s civil society weather this storm. Many civil society organizations were left unsure of how to engage at the national and international levels to advocate for their cause due to a lack of clear communication and support from the Namibian government.  “We wonder if civil society organizations will be consulted on how the country is going to respond to this funding challenge, so that we also contribute to the solutions,” said one participant, highlighting the need for civil society to be closely involved in the response to this unprecedented challenge.

Exploring alternative funding sources, including from the private sector and other partners, was deemed essential. All partners called for a united front, with CSOs coming together not only to advocate for the reversal of the Executive Orders but also to explore ways to ensure continued support for Namibia’s most vulnerable populations.

As a way forward, CSOs were urged to complete a rapid assessment tool to better understand the immediate effects of the funding cuts, as data collection and monitoring are crucial in advocating for the continued support of affected communities and developing detailed action plans and strategies.

Strengthening partnerships, supporting mental health and psychosocial well-being, and engaging with the government are also key to ensuring that Namibia’s civil society could survive in these uncertain times.

Despite all, Namibia’s civil society remains determined. While the challenges are significant, the collective power of advocacy, solidarity, and collaboration offers a glimmer of hope for the future. It is through these unified efforts that Namibia’s most vulnerable communities may continue to receive the care, support, and recognition they deserve.