Neftaly Tuberculosis Program – Namibia
Project Duration: 01 June 2006 – 31 May 2011
Project Title: Scaling Up Tuberculosis Prevention, Diagnosis, and Treatment in High-Burden Regions of Namibia

Background

Namibia has one of the highest tuberculosis (TB) incidence rates in the world, exacerbated by its high HIV prevalence. During the mid-2000s, the country faced significant challenges in TB case detection, treatment adherence, and rising cases of drug-resistant TB (DR-TB). Health systems were under strain, particularly in rural and underserved regions, and many patients lacked access to timely diagnosis and care.

In response to this urgent public health need, Neftaly launched a five-year initiative in partnership with the Ministry of Health and Social Services (MoHSS) to support Namibia’s National TB and Leprosy Programme (NTLP). The program focused on expanding TB control services, building health system capacity, and integrating TB/HIV interventions.

Program Objectives

• Increase TB case detection and improve diagnostic accuracy
• Enhance treatment success rates and reduce loss to follow-up
• Strengthen TB/HIV collaborative services
• Build capacity of health workers, laboratories, and community health systems
• Lay the foundation for the management of multidrug-resistant TB (MDR-TB)

Strategic Interventions

1. Case Detection and Laboratory Strengthening

• Expanded access to TB testing through microscopy centers and trained lab technicians across all 13 regions
• Established quality assurance systems for sputum smear microscopy
• Improved specimen transport systems to reduce turnaround time for results

2. Access to Treatment and DOT Implementation

• Scaled up the Directly Observed Treatment, Short-course (DOTS) strategy at facility and community levels
• Trained healthcare workers and community volunteers to support treatment adherence and follow-up
• Supplied first-line TB medications and ensured regular monitoring for side effects and outcomes

3. TB/HIV Collaborative Activities

• Integrated TB screening and HIV testing in all TB clinics
• Provided co-trimoxazole prophylaxis and antiretroviral therapy (ART) to co-infected patients
• Supported joint TB/HIV training programs for frontline health workers

4. Community Engagement and Health Education

• Conducted widespread awareness campaigns to reduce stigma and promote early care-seeking behavior
• Engaged traditional leaders, churches, and civil society organizations in TB prevention messaging
• Supported patient support groups and peer-led education initiatives

5. Health System and Capacity Building

• Trained over 1,500 health workers in TB case management, infection control, and TB/HIV integration
• Strengthened program supervision, data management, and reporting through district and regional TB coordinators
• Supported the development of TB policy guidelines and national strategic frameworks

Results and Impact (2006–2011)

• TB case detection improved by over 30% in supported regions
• Treatment success rates exceeded 80%, surpassing national targets in several districts
• Over 90% of TB patients were tested for HIV, improving linkage to care
• Community DOTS coverage expanded to more than 80% of rural health districts
• National capacity for MDR-TB preparedness and response was significantly enhanced
• Strengthened laboratory network and human resources across the TB care cascade

Conclusion

Neftaly’s five-year TB intervention in Namibia was instrumental in expanding equitable access to TB services, improving patient outcomes, and laying a strong foundation for future TB and DR-TB response efforts. By investing in communities, health systems, and frontline workers, the program helped reduce the TB burden and aligned Namibia’s efforts with global Stop TB Partnership goals.