The conclusion of Project Okambilimbili in July 2009 signaled the end of a successful venture that saw the establishment of sustainable AIDS treatment options, a multifaceted treatment literacy venture and more than 36 000 people in Namibia benefiting from health subsidies.

The two-pronged project comprised a treatment subsidy and a treatment literacy component. The treatment subsidy aspect directly funded medication to 100 poor HIV+ patients in need of HAART. It also developed a health insurance together with an appropriate subsidy mechanism making it more affordable to 10 000 people and provided external support to manage the quality of care provided through the insurance to patients.

The treatment literacy component of the project focussed on providing care and treatment support to PLWHA (either individually or in groups) and to employer groups / companies. Within companies, the programme offered comprehensive advice around implementing or improving the content of their workplace programs by combining prevention, education, care and treatment elements.

Both the treatment literacy and treatment subsidy programmes ended in December 2008, having:

Treatment subsidy

• Supported the development of three new affordable healthcare packages especially for low to middle income employees
• Supported the development of a risk equalization pool to facilitate the sharing of risk which reduces the cost of healthcare insurance and results in greater affordability of health care products
• Supported the development of a quality assurance system to monitor the level of care provided for HAART patients on the new healthcare products
• Supported the training and development of clinicians and medical personnel in the clinical management and monitoring of HAART

Treatment literacy, including resource mobilization & advocacy

• Supported the development and implementation of a formal treatment literacy campaign aimed at mobilizing the private sector to provide access to general healthcare and HAART for all employees
• Supported the development of the Healthy Workforce, Healthy Business campaign with the Namibia Business Coalition on AIDS, which started in 2006 and is ongoing
• Supported the development of the ‘Have you taken your ARV’s today?’ campaign in 2007 with Lironga Eparu, the national body for PLWHA
• Assisted in strengthening community structures to provide support to PLWHA

For the period January 2009 - July 2009, the project received a no-cost extension from the Postcode Loterij and the AIDSFONDS to support the implementation of on-site voluntary counselling and testing in workplaces through our Bophelo! partnership.

After the cessation of the subsidy earlier in December 2008, the following six months were utilized to monitor the performance and development of the affordable health care products. This review revealed the continuous growth of new affordable health insurance products without any external donor subsidy support. It also revealed that, by July 2009, the number of newly insured (previously uninsured) people on the new affordable healthcare product had grown by more than 5 percent without any further donor subsidies being present. The removal of the subsidy, from both the subsidized products and unsubsidized product therefore did not have a negative influence on the continuation of the affordable health care products that were created and subsidized during project Okambilimbili.

Project Okambilimbili has proven to be very innovative, having initiated changes in the landscape of Namibian private health insurance perspective on affordable medical insurance, as well as producing a number of spin-off programs. These include a PMTCT programme for HIV+ mothers, a nutritional support programme for HIV+ children and a care and support programme for HIV+ children, orphans and other vulnerable children. The programme further initiated the first private mobile clinics in Namibia, which provides health-screening services on-site in remote workplaces.