Funding and Implementation

The CDC Cooperative Agreement (CoAG) implementing partners, including the Ministry of Health and Social Services (MoHSS), have received approval and funds to implement the Co-Ag from April to September 2025, pending final review from the US Government. 

Impact on Services

• ART Services: Facilities providing antiretroviral therapy (ART) are operating at full capacity, but there are challenges with paediatric HIV treatment services, due to disruptions in referrals and linkages.
• Community Health Workers: Funding cessation has affected community health workers responsible for adherence support and retention.
• Data Collection: Data collection continues at all facilities, but data quality control and collation are impacted.
• Stock Availability: ARV supplies, HIV, viral load and other lab test kits are available with minimal disruption. However, there are intermittent condom stock-outs, which may worsen in the next 3-6 months if procurement and supply chain issues, including condom distribution are not urgently addressed.
• Service Disruptions: Reduced capacity in community-based paediatric HIV services, HIV prevention and community health worker programs.

Primary HIV Prevention Services

• Disruptions: There are disruptions in the distribution of condoms and other prevention commodities, reduced availability of pre-exposure prophylaxis (PrEP) services, suspension or reduction of HIV prevention education and awareness campaigns, decreased access to HIV testing and counselling services, delays or disruptions in community-based HIV prevention outreach programs, limited or suspended implementation of voluntary medical male circumcision (VMMC) services, and reduction in funding for HIV prevention, research and innovation.

Impact on Key Populations

• Adolescent Girls and Young Women (AGYW): Disruption in access to PrEP services, reduced capacity of service delivery points, discontinuation of some outreach programs, reduced availability of HIV testing services, reduced availability of education and awareness campaigns, and reduction in counselling and social support services.
• Sex Workers, MSM, and Transgender Persons: Disruption in access to PrEP services, reduced capacity for HIV prevention services, , reduced availability of HIV counselling and testing, and disruption in access to antiretroviral therapy services as well as adherence and retention support.
• Human rights, key and vulnerable populations Namibia received PEPFAR funding for work on stigma, discrimination and enabling legal environments. These included USAID-led LIFT UP Equity Incentive initiative, which was supporting efforts to strengthen human rights and equity for Key Populations, AGYW and children (priority populations) to new and groundbreaking levels. Most programs have now resumed with some work  ongoing with reduced capacity. This funding has not been redirected to other programs. Some communities have not been collecting data on human rights issues, including increased levels of stigma and discrimination and health service delivery monitoring, due to not receiving the funds, while others have received some funding. One major assignment affected by the cuts is the Key Population Integrated Biobehavioral Survey (KP IBBS) 3, which focused on gay men and other men who have sex with men (MSM), female sex workers (FSW), and transgender women. The survey had just started, but had to be halted due to the funding cuts,

Civil society impact, resilience and response: The impact of the US Government cuts on community-led organizations service delivery includes reduction or suspension of services (at community-led or peer-led facilities and services, and international NGO-run services), increased demand with fewer resources, loss of staff and funding cuts. CLOs also face reduced participation in policy discussions and limited ability to advocate for key issues, as well as reduced ability to collect and report data.

Politically Relevant Updates

• Government Actions: The Minister of Health has briefed the Cabinet, and the National Planning Commission has been tasked to coordinate stakeholder engagement. The Sustainability Planning Steering Committee is planning for the implementation of the Sustainability Roadmap, and will among others, conduct a gap analysis using the UNAIDS RAFT tool to highlight the critical funding gaps to be presented to the leadership.
• Taskforce Formation: The National Planning Commission has been tasked to form a taskforce to coordinate stakeholders’ engagement to respond to the US Government shift impact, although the timeline is unclear.