HIV in Zambia MINISTRY OF HEALTH. Dr Albert Mwango, BScHB, MBChB, MPH National Antiretroviral Program Coordinator,
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1 HIV in Zambia Dr Albert Mwango, BScHB, MBChB, MPH National Antiretroviral Program Coordinator, MINISTRY OF HEALTH 8th INTEREST WORKSHOP Intercontinental Hotel, Lusaka May 5 th -9 th, 2013
2 Background Clinical and public health significant issue Can be stigmatizing and usually affects already vulnerable populations 8th INTEREST
3 Background Heterosexual HIV epidemic Prevalence 14.3% in adults Currently new infections are at 1.1% per year 2012 Zambia UNGASS Report 8th INTEREST
4 Background New infections rate in % among males 1.25% among females 9% (at 6 weeks) in exposed children Currently new infections are at 1.1% per year 2012 Zambia UNGASS Report 8th INTEREST
5 HIV Drivers Multiple and concurrent sexual partners Low and inconsistent use of male and female condoms Mobility and labour migration High risk sex work Mother to Child Transmission (MTCT) Sexually Transmitted Diseases (STDs) 8th INTEREST
6 Zambia Estimates for Adults and Children Estimates People living with HIV 1.2 million New HIV infections Deaths due to AIDS 66,500 adults 9,500 children 29,200 ZAMBIA -UNGASS 2012 Report 8th INTEREST
7 Program Goals 2015 Goals, cut new infections: In women and men by 50% obaseline -2011/2012 Among children to < 5% transmission DHHS Guidelines for Antiretroviral Therapy in Adults and Adolescents. March th INTEREST
8 ART in Zambia Patients on ART Eligible and on ART ,490 (Adult coverage - 94%) 49,416 (Children coverage 55%) Patients on ART 8th INTEREST
9 Significant ART Policy Changes : Introduction of ART in public sector 2005: Cost sharing system replaced with Free ARVs policy 2005: Introduction of Routine CT 2005: Roll out of ART to Health centre level 2006: Adoption of One M & E System 9
10 Significant ART Policy Changes : Introduction of full supply ART logistics system 2007: Accreditation system 2007: Revision of ART protocols in favour of TDF based regimens 2009: Introduction of mobile HIV services 2012: Introduction of Advanced Treatment Centre for third line ART 8th INTEREST
11 Significant ART Policy Changes : Adoption of lifelong ART for prevention & treatment in P/BF women 2013: Development of 1st consolidated treatment & prevention guidelines 11
12 Progress Many advances have been made in the treatment and prevention of the effects of HIV in Zambia > 58% reduction in new HIV infections from 2009 to 2012 > 90% access cart of those eligible 8th INTEREST
13 Progress Many advances have been made in the treatment and prevention of the effects of HIV in Zambia Provision of 1 st, 2 nd and 3 rd line treatment free of charge. Over 9 times increase ($5m to $45m) in ARVs budget in 3 years New guidelines moving us close to test and treat 8th INTEREST
14 PMTCT Coverage PECENTAGE COVERAGE Zambia has made significant progress in eliminating mother to child transmission (emtct) Coverage expanding since 2008 and now >95% with option A Now in the process of transitioning to Option B+ 25% 20% 15% 10% 5% 0% Risk of infants acquiring HIV infection from their mother (at 6 weeks) 22% 9% th INTEREST
15 Key changes in new guidelines Children (0-15y) Adults (>15y) Treat irrespective of CD4 or WCS Treat* when CD4<500 or WCS 3 or 4 WCS WHO Clinical Stage 8th INTEREST
16 HIV Counselling and testing Strengthened mobile HTC facilities Strengthened youth friendly HTC centres that offer adolescent friendly sexual and reproductive health services Increasing outreach of couple VCT 8th INTEREST
17 MULTI Sectroial response Critical Enablers Gender Equality & GBV Laws, Legal policies & practices Political Commitment & Governance Resource Mobilisation Coordination & Management Health System Strengthening Community System Strengthening High Impact Interventions HIV Counselling and Testing PMTCT Condom Programmes Voluntary Medical Male Circumcision ART BCCC Key Populations Reduce Risk Reduce likelihood of transmission Reduce mortality & morbidity 8th INTEREST
18 Conclusion Zambia s HIV response has grown over the years It has shown to be dynamic and innovative The country s response is robust in achieving its goals and has began to show results 8th INTEREST
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