DREAMS in Namibia
At one point, Namibia had the highest HIV prevalence rates globally. In the country, HIV disproportionately impacts young women, with their incidence rates being several times higher than those for men. However, the Namibian government and the President’s Emergency Plan for AIDS Relief (PEPFAR) wanted to change the narrative for the country. To help, PEPFAR funded Namibia with $50 million for treatments and resources.

New HIV infections have decreased by 50% since 2004. Namibia now has an estimated 85.4% of viral suppression and 8.3% HIV prevalence, according to a Namibia Population-based HIV Impact Assessment (NAMPHIA) report. Through the partnership, the Namibian government and PEPFAR were able to give people DREAMS in Namibia.

DREAMS Project

DREAMS (the acronym for Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) first launched on World AIDS Day 2014 with private sector partners such as the Bill & Melinda Gates Foundation, Girl Effect, Gilead Sciences, Johnson & Johnson and ViiV Healthcare. The DREAMS Project works to address leading factors for increased vulnerability in adolescent girls and young women (AGYW) with HIV. The project has created change in 15 countries including Botswana, Cote d’Ivoire, Eswatini, Haiti, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Tanzania, Uganda, Zambia and Zimbabwe. By doing so, it has pushed partner governments to renew their commitments to gender equality and the impact on adolescent health and development.

The U.S. Department of State mentioned on World AIDS Day 2020, data showed new HIV diagnoses among AGYW declined in countries implementing DREAMS, with 96% of which had a decline of more than 25% and almost 62% of which decreased by more than 40%.

Of the 15 countries, DREAMS in Namibia officially launched in October 2017. The U.S. Embassy noted the project is focusing on three regions: Khomas, Oshikoto and Zambezi. While the primary target of DREAMS in Namibia are AGYW ages 9-24, orphans and vulnerable children, the male sexual partners aged 20-49 are a part of the targeted population.

DREAMS and Project Hope

The DREAMS project is also partnering with Project HOPE Namibia. Project HOPE similarly works to mitigate the impact of HIV by safeguarding access to quality health care for vulnerable populations. Through the partnership, more than 100,000 orphans and vulnerable children with household services, loans and startup kits for their caregivers.

In partnership with DREAMS in Namibia, Project HOPE empowered more than 20,000 AGYW across Namibia with education on HIV, job skills and financial literacy. Project HOPE also offers clinical support for survivors.

On February 23, First Lady Jill Biden visited Hope Initiative Southern Africa to listen in on the testimonials of those that DREAMS in Namibia increasingly impacted. Among the testimonials, the common theme was that these young women’s voices grew and obtained more opportunities to kick-start their businesses.

Looking Ahead

Namibia is still fighting against the HIV epidemic. However, DREAMS in Namibia continues to reach the masses of those who are HIV infected by changing one life at a time. The project allows those infected to pursue their dreams.

Brianna Green
Photo: Flickr

HIV PreventionNearly 1,000 sub-Saharan young women are infected with HIV every day. Women accounted for more than half of the 25.8 million people living with HIV in 2014.

From 2012 to 2015, more than 4,500 women participated in two distinct open-label studies designed to test a new HIV prevention method. ASPIRE was designed to determine if dapivirine, an experimental antiretroviral drug, could safely and effectively prevent HIV infection. The International Partnership for Microbicides (IPM) developed the dapivirine silicone vaginal ring. Each ring carries 25 mg of dapivirine and slowly releases the drug over a period of time.

The ASPIRE test was conducted at 15 sites in Malawi, South Africa, Uganda and Zimbabwe where 2,629 women enrolled to participate. ASPIRE’s sister study, The Ring Study, enrolled 1,959 women aged 18 to 45 in six sites in South Africa and one site in Uganda. Data revealed that when consistently released and replaced every four weeks, the dapivirine ring reduced the risk of acquiring HIV by 37 percent.

In women 25 years and older it reduced the risk of infection by 61 percent. Although more successful than anticipated, analysis found that sub-Saharan young women appeared to use the ring less consistently than older participants.

ASPIRE’s follow-on trial, HIV Open-Label Extension (HOPE) is currently under way. It is designed to determine how the ring could fit into women’s lives, any relationships between adherence and HIV protection, and why dapivirine will work for some women and not others.

Last but not least is the USAID-funded Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS) Initiative. DREAMS is set to reduce HIV infection in women ages 15 to 28 in Kenya, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. By the end of 2017, DREAMS will achieve a 40 percent reduction in HIV incidence among adolescent girls and young women.

In addition to providing sub-Saharan young women with the new HIV prevention method, DREAMS will provide HIV counseling and testing, education subsidies, post-violence care, access to youth-friendly sexual and reproductive health services and parenting and caregiver programs.

With the continued development and implementation of programs like these, young women in sub-Saharan Africa will be able to live empowered, independent lives free from disease and with opportunities for prosperity.

Tiffany Santos

History is full of unsung female heroes, and the story of the fight against disease is no exception. March 8 is celebrated as International Women’s Day, and global health organizations worldwide took the opportunity this year to recognize amazing women who have made, and continue to make, important contributions. Here are five awesome women who fought disease:

 1. Lady Mary Wortley Montagu, 1689-1762

Lady Montagu was almost singlehandedly responsible for introducing inoculation to Western medicine. An accomplished poet and letter writer, Montagu became an advocate for global health after she witnessed a smallpox vaccine being administered during a visit to the Ottoman Empire. She used her writing skills to defend the practice at home in England, where she defied European doctors by having her son Edward vaccinated.

 2. Dr. Isabel Morgan, 1911-1996

Instrumental in the fight against polio, Morgan broke new ground in the medical understanding of vaccines with her work during the 1940s. She and her team proved that “killed-virus” vaccines were effective in the creation of antibodies in the immune systems of monkeys, preventing the virus from passing the blood-brain barrier. Thanks to her research, a safe and effective vaccine for humans was created and continues to save lives today.

3. Dr. Rebecca Lee Crumpler, 1831-1895

Crumpler challenged the status quo by becoming the first African-American woman to earn an M.D. She devoted her practice to caring for freed slaves and the poor after the end of the Civil War in 1865. Her written work published in 1883 Book of Medical Discourses, which contains a brief autobiography of her career, is one of the first medical references in the U.S. authored by an African-American individual.

4, Henrietta Lacks, 1920-1951

Lacks fought disease in a most surprising fashion: with her own cellular tissue. After being diagnosed with cervical cancer at age 30, Lacks provided a sample from a tumor that contained what medical research refers to as “immortal” cells. Her cells were code-named ‘HeLa cells’ by doctors and researchers. These particular cells are able to survive indefinitely in a laboratory environment, for reasons still partially unknown to science. They have been used to learn more about everything from developing vaccines to cellular behavior in zero gravity environments.

5. Nontokozo Zakwe, 1993-current

Zakwe is living proof that even without medical degrees, girls can grow up to become awesome women who fought disease. Zakwe is a volunteer and ambassador for the DREAMS partnership across 10 African countries, led by the U.S. President’s Emergency Plan for Aids Relief (PEPFAR). After being inspired by her mother’s battle with HIV, Zakwe continues to raise awareness and provide education for preventing the spread of the virus throughout the world.

On International Women’s Day 2017, the Joint United Nations Programme on HIV/AIDS (UNAIDS) released a report outlining its impressive goals to reduce the number of girls and women infected by the virus by providing access to reproductive health options to 90 percent of the population by 2020. Among the ranks of those working to achieve that reality, there will surely be more pioneering women in the global fight against the disease.

Dan Krajewski

Photo: Flickr