Historical Background

In Zambia the first HIV case was reported in 1988 and by 1991 the Zambia National AIDS Program had recorded 15,000 cases which accounted for 14% of the total deaths.[1] In 1988 the estimated adult prevalence rate (15 -49 years) was 19% while approximately 90,000 had died of AIDS.  HIV&AIDS now became the greatest threat to development in Zambia which eroded macro-economic growth, human capital development and growth in the labour productivity. Life expectancy plunged from 54 years in the mid 1980’s to 37 years in 1998. 25,000 newborns were born with the virus each year which led to the worsening of infant mortality. By 1999, Zambia had over 500,000 orphans defined as loss of one or both parents due to AIDS. By any standard this was an enormous burden of disease for the population of Zambia which then stood at 9.1 million people.

The impact of AIDS on the health of the population of Zambia reverberated for society as a whole. In the agriculture and mining sectors, production became inhibited as labor time was reduced due to sickness or the need to care for sick family members.  This was the same for other sectors such as education. Assets such land, equipment and livestock had to be sold to raise funds to take care of the sick.     The impact on the health care system became profound.

This catastrophic scenario demanded that the Government of the Republic of Zambia and society as a whole act immediately by setting up the National AIDS Control Program in 1986 and developing a short term emergency plan in 1988 - 1992 to protect blood supply.  The designation of the AIDS epidemic as an emergency was resoundingly affirmed at the 11th International Conference on AIDS and STIs in Africa which was held in Zambia in 1999.

Three years later, the National HIV/AIDS/STI/TB Council (NAC) was established through an Act of Parliament No.10 of 2002 to coordinate the national multi-sectoral AIDS response.  This mandate of the council was further consolidated by the adoption of the “three-ones principle” suggesting that for effective coordination of the national response, countries should have one national coordinating authority, one national strategic framework (NASF) and one national monitoring and evaluation (M&E).