Dr David N Emvula
Dr David N Emvula

Fertility treatment is a right, not a luxury

Dr David N Emvula
Infertility is not a lifestyle choice. It is a medical disease. The World Health Organisation classifies it under an Implantable Cardioverter-Defibrillator (ICD) 10 alongside conditions such as cancer, diabetes and HIV and AIDS. Yet in Namibia, couples struggling with infertility are left on their own as both public healthcare and private medical insurance exclude fertility treatment. This exclusion is not only unjust but also discriminatory.



Globally, one in six couples face infertility, and in Africa the prevalence rises to one in four. The inability to conceive carries profound emotional, social and psychological consequences. In a society where childbearing is tied closely to cultural identity and marital stability, infertility often leads to stigma, isolation and mental health struggles. Despite being a recognised disease, access to treatment remains denied.



One common argument is that fertility care is too costly for governments or insurers to support. However, the numbers tell a different story. A single In Vitro Fertilization (IVF) cycle in Namibia costs between N$60 000 and N$100 000, with many patients needing only one or two cycles. This pales in comparison to cancer treatment, where chemotherapy and radiation can range from N$150 000 to more than N$500 000 per patient. HIV and AIDS care, fully funded by the state and private insurers, requires lifelong antiretroviral therapy costing between N$4 000 and N$8 000 annually, often surpassing N$200 000 over a patient’s lifetime. While support for cancer and HIV and AIDS is rightly provided, infertility remains excluded. Couples are doubly disadvantaged, denied assistance by both state and private sectors, with nowhere to turn.



Patients do not choose to have endometriosis, polycystic ovary syndrome or blocked fallopian tubes, all of which are medical causes of infertility that impose enormous personal burdens. Expecting them to shoulder all financial and emotional costs without support reflects systemic discrimination, not equitable healthcare. Achieving Sustainable Development Goal 3, particularly target 3.7 on reproductive health, requires that infertility care be part of universal sexual and reproductive health services. Denying this violates fundamental reproductive rights.



Infertility is a serious disease that deeply affects mental health, relationships and self worth, with women often facing the harshest stigma. If Namibia is to live up to its commitment to equitable healthcare, infertility must be recognised as a public health priority. Outsourcing fertility services to private clinics, as is already done with cancer treatment, could provide an immediate solution while the country develops its own public fertility services. Establishing a fertility unit at Windhoek Central Hospital and investing in the training of specialists, embryologists and nurses would ensure sustainable and affordable access to care.



Equity in healthcare means treating all diseases with fairness and compassion. If Namibia can fund lifelong HIV and AIDS treatment, costly cancer therapies and diabetes management, then it can and must extend support to couples longing for children. Fertility treatment is not a luxury. It is a medical necessity. What is needed is political will, compassionate policy and a genuine commitment to reproductive health for all.



Disclaimer: References to cancer, diabetes and HIV and AIDS are made only to illustrate healthcare priorities and costs. The intention is not to diminish these conditions but to highlight the unfair disparity in how infertility, an equally recognised disease, is treated.

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Republikein 2025-09-30

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