In Namibia, the WHO World Health Report (2004) indicates an adult mortality¹⁴ rate per 1000 population of 605 for males and 529 for females. Life expectancy for males is 48.1; for females 50.5. Healthy life expectancy is 42.9 for males; 43.8 for females.¹⁵

HIV/AIDS is a huge burden for sub-Saharan Africa. Throughout the region in 2003, an estimated 23-27 million people were thought to be living with the disease which also caused up to 2.5 million deaths. This represents a huge loss and impacts significantly on health systems and social and family structures.

Namibia is severely affected by the HIV/AIDS crisis affecting countries in Southern Africa. Estimates suggest that in Namibia, between 180,000 and 250,000 people were living with HIV/AIDS at the end of 2003. In the same year, up to 22,000 adults and children are thought to have died from the disease (Table 2).

Table 2 Country HIV and AIDS estimates, end 2003

UNAIDS reports:

Existing and anticipated poverty levels have significant implications for the spread of HIV and other diseases. Poverty is associated with food insecurity; parents of about 30% of all children are unable to provide nutritious food of adequate quality and required frequency. Based on the report of the 2002 National HIV Sentinel Survey published by the Ministry of Health and Social Services (MHSS), the HIV/AIDS prevalence rate among pregnant women attending antenatal care was estimated at 22%. Half of Namibia's population survives on approximately 10% of the average income. The national unemployment rate is 35%, and there is a significant disparity in income distribution across the population.

he greater burden of the epidemic falls on women. HIV infection amongst young women accounts for 50% of all reported HIV infections. Current estimates put the number of orphans at 82 000, expected to rise to 120,000 by 2006. Namibia's proposal to the Global Fund to Fight AIDS, Tuberculosis and Malaria second round was approved in January 2003. The government has responded to the request for revision of some components of the proposal. The total amount for the three components for five years is US $113,157,021, of which US $105,319,841 is for HIV/AIDS. Namibia is one of the priority countries to benefit from the US Presidential Plan for AIDS Relief (PEPFAR).¹⁶