CCM Zambia of the Global Fund
Background
Zambia has made significant progress towards reversing the HIV and TB epidemics over the last decade. The number of new HIV infections has fallen by 23% and TB incidence has fallen by 54%. In order to sustain these gains, Zambia has demonstrated its commitment towards building resilient and sustainable systems for health (RSSH). Improvements in the order, warehousing, and distribution systems will enhance the availability of medicines and health products at all health facilities.
An estimated 1,296,903 people are living with HIV (PLHIV) of which 92% of PLHIV know their status, 87% are on ART, and 76% are virally suppressed. Despite this progress, gender- and age-related disparities remain, e.g. in the age group 15-24, HIV infections of females are more than tenfold compared to males. There are also geographical disparities in new HIV infections: Of the total 18,486 new infections among adolescents and young people 15-24 years, 80% (14,800) occur in 40 districts. Condom use with non-regular partner is estimated at roughly 50%.
WHO classified Zambia as one of the 10 countries worldwide with a high burden from TB, HIV-associated TB and drug resistant TB. TB is among the top 10 causes of morbidity and mortality accounting for over 40% of deaths among PLHIV. The estimated incidence in 2018 was 346 per 100,000 population. Prevalence is higher in the urban than in the rural as well as in HIV positives, in men and in the age group 25-44 years. The proportion of TB patients with multi-drug or Rifampicin resistant tuberculosis was 2.8% among new cases, and 18% among previously treated cases, with an estimated 3,100 drug resistant (DR-TB) incident cases in 2018.
Goals
- Reduce new HIV infections from 51,000 in 2019, by at least 50% by 2023
- Reduce AIDS related mortality by 50% from 20,000 in 2019
- Reduce HIV related stigma and discrimination by 50%
- Mother to child transmission of HIV eliminated, from 3.7% in 2019 to less than 3%, by
2023 - To reduce the number of TB deaths in the population by 40% in 2021 compared to 2015
Strategies
| HIV | TB |
|---|---|
| To achieve 90% of PLHIV knowing their status | To increase the number of notified cases of new TB episodes from 36,700 in 2015 to at least 59,000 in 2021 |
| To achieve 81% of PLHIV on ART | To increase the treatment success rate for TB from 85% in 2014 to at least 90% from 2018 |
| To achieve 72.9% of PLHIV having viral load suppression | To increase the detection of MDR-TB patients from 99 in 2015 to 1,200 by 2021 |
| To reduce new HIV infections to 18,000 or fewer by 2020 | To increase treatment success rate for MDR-TB patients from 33% in 2013 to 80% by the year 2021 |
| Achieve zero stigma and discrimination by 2020; and | Scale up comprehensive TB/HIV collaborative activities to all facilities by 2021 |
To increase domestic financing of the response by 50% |
Strengthen management, leadership and governance of the NTLP by 2021 |