At a glance
CDC works with partners in Malawi to strengthen the country's public health and clinical systems, deliver quality HIV testing and treatment services, and respond to emerging public health threats.
Background
The CDC Malawi office collaborates with the Government of Malawi's (GOM) Ministry of Health (MOH) and non-governmental organizations to implement HIV programs. CDC supports:
- The use of pre-exposure prophylaxis (PrEP) for those at high risk of contracting HIV.
- HIV testing and counseling.
- Prevention of HIV transmission.
- Antiretroviral treatment (ART).
- Uptake of voluntary medical male circumcision (VMMC).
In addition, CDC continues to support the U.S. President’s Emergency Plan for AIDS Relief's (PEPFAR) Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe (DREAMS) program. The DREAMS program addresses social factors that put adolescent girls and young women at risk for HIV disease.
Scaling up tuberculosis (TB) preventive treatment (TPT) promotes epidemic control by reducing TB incidence among people living with HIV (PLHIV). CDC's strategic focus in Malawi is to collaborate with implementing partners to:
- Build public health capacity and infrastructure.
- Strengthen surveillance and health information systems.
Download CDC Malawi's Fact Sheet
HIV and TB data
HIV/AIDS
Estimated HIV Prevalence (Ages 15-49)
Estimated AIDS Deaths (Age≥15)
Estimated Orphans Due to AIDS
Reported Number Receiving Antiretroviral Therapy (Age≥15)
Tuberculosis (TB)
Estimated TB Incidence
TB Patients with Known HIV-Status who are HIV-Positive
TB Treatment Success Rate
Key activities and accomplishments
Building public health capacity and infrastructure
According to the 2020–2021 Malawi Population Based HIV Impact Assessment (MPHIA), Malawi has achieved 88-98-97 of the Joint United Nations Program on HIV/AIDS 95-95-95 targets:
- 95 percent diagnosed among all PLHIV.
- 95 percent on ART among those diagnosed.
- 95 percent virally suppressed among those treated.
CDC supports innovative interventions to optimize case findings. This includes scaling-up active index testing and piloting outpatient screening tools to reduce testing volume and improve positivity rates. Implementing partners are expanding patient-centered care and identifying and addressing bottlenecks affecting continuity in treatment.
In addition, implementing partners are providing psychosocial support and access to comprehensive TB/HIV prevention, care, and treatment services. Examples include:
- VMMC
- PrEP
- Differentiated service delivery models
- Advanced HIV disease services
Continuous quality improvement has recently expanded to include optimizing TPT completion rates.
Increasing public health and clinical health expertise
CDC supports increasing Malawi’s epidemiological capacity through the Field Epidemiology Training Program (FETP). Since 2016, Malawi’s FETP has trained more than 190 frontline health workers over 17 cohorts to respond to health threats. The first intermediate FETP cohort in 2022 trained 12 field epidemiologists. CDC has supported more than 3,000 nurses, clinicians, laboratory staff, data clerks, and lay cadres since 2017.
Strengthening laboratory systems
CDC supports MOH to establish and maintain quality-assured laboratory diagnostic services for HIV, TB, HPV, and other non-communicable diseases. CDC also supports the Public Health Institute of Malawi (PHIM) to develop the capacity to address emerging and re-emerging diseases.
To sustain the national quality assurance program, PHIM’s reference laboratories are producing specimen genotyping and proficiency panels for TB, HIV, Syphilis, and Hepatitis B tests.
CDC continues to assist conventional and point-of-care testing molecular laboratories to achieve 95 percent of HIV viral load coverage and to diagnose all infants that were exposed to HIV.
CDC supports 14 conventional molecular laboratories with infrastructure, equipment maintenance, human resources, data management, and biosafety. Laboratories are implementing a quality management system, and as of 2023, nine laboratories achieved international accreditation for HIV viral load testing.
CDC also supports an integrated sample transportation system covering 790 facilities across all districts to ensure laboratory services are accessible to clients. Additionally, CDC has seconded subject matter experts to strengthen MOH’s central coordination and monitoring of activities.
Strengthening surveillance and health information systems surveillance
CDC supports MOH to establish and scale up surveillance systems and programs including:
- Birth and death registration with cause-of-death reporting
- Birth defects surveillance in sites to evaluate the association between ART and birth outcomes
- HIV drug resistance surveillance
- HIV infection surveillance system in 27 of 28 districts in Malawi
CDC supported the 2020−2021 MPHIA to assess progress made in addressing gaps identified in the 2015−2016 survey. In FY 2023, CDC plans to estimate the number of people at higher risk of HIV, including biological and behavioral surveillance among:
- Female sex workers.
- Male sex workers.
- Men who have sex with men.
- Transgender women.
Establishing electronic monitoring systems
CDC has supported the establishment of electronic medical record (EMR) systems at more than 760 HIV treatment sites. The system covers all clients on ART in Malawi. The systems aid in the clinical management of HIV clients, supply chain management, and reporting geographical distributions of HIV cases by age and gender.
CDC has also invested in improving infrastructure to facilitate EMR use and established a support helpdesk to respond to assistance requests.
Resources
Support for CDC's global HIV and TB efforts.
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