June 13, 2024

HIV and TB Overview: Zambia

CDC works with partners in Zambia 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 office in Zambia has a long-standing partnership with the Ministry of Health (MOH) and its provincial health offices. Over the past 20 years, CDC has supported the MOH in scaling up HIV prevention and treatment programs.

In the last year, CDC has focused on increasing access to evidence-based, high-impact combination prevention. CDC has also focused on equitable and enhanced case identification and linkage for pediatrics, adolescents and young persons, and key populations. Another focus is improving quality and sustainability of HIV services, including integration of primary care services, non-communicable diseases and mental health.

Additionally, CDC has leveraged the systems established by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). This helped build the capacity of local institutions to prevent, detect, and respond to existing and emerging public health threats.

Download CDC Zambia's Fact Sheet‎

Learn more about CDC's global HIV and TB work in Zambia.

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

HIV epidemic control

With over 1.3 million people living with HIV (PLHIV), Zambia is one of the countries most affected by HIV globally. HIV is the leading cause of death in Zambia. With support from PEPFAR, CDC coordinates bilateral and diverse multistakeholder engagement to support a sustainable, equitable, high-impact national HIV response.

As a key PEPFAR implementing agency, CDC focuses on achieving joint United Nations Program on HIV/AIDS (UNAIDS) 95-95-95 targets. These HIV epidemic control targets include:

95% diagnosed among all PLHIV.
95% on antiretroviral therapy (ART) among those diagnosed.
95% virally suppressed among those treated.

CDC is also implementing PEPFAR’s 5-year strategy through a data driven and informed health equity lens. This strategy works to close gaps for children, adolescents, young people, and key populations across the cascade and continuum of care.

PEPFAR data in March 2023 showed 87 percent of PLHIV in Zambia are on ART. The same data showed viral load suppression among persons on ART was > 95 percent. In comparison, children < 15 years living with HIV (CLHIV) lag in the attainment of the UNAIDS targets. Approximately 70 percent of CLHIV know their status and are on ART. However, viral load suppression has steadily increased to 93 percent with wide implementation of pediatric dolutegravir.

CDC supports evidence-based HIV programs to reduce new HIV infections and HIV-related deaths in Lusaka, Southern, Eastern, and Western provinces. Key strategies used include:

Enhancing advanced HIV care.
Scaling up differentiated and integrated health service delivery models.
Implementing targeted case-finding approaches.
- Includes HIV index patient testing, hot-spot mapping, and social networking HIV testing.
Retaining clients on care.
Rational appointment systems.
Promoting HIV viral load literacy to enhance viral load coverage.

TB and HIV

TB is the leading cause of death among PLHIV. CDC’s efforts focus on integrating HIV and TB case management. This includes bidirectional HIV and TB case finding and integrated treatment services, including TB prevention and infection prevention and control. CDC currently supports the MOH and implementing partners to find, identify, treat, and prevent TB among PLHIV.

Efforts include:

Expanding access to better TB screening.
Contact tracing.
Diagnostics support to reduce missed cases, especially among pediatric populations.

Additionally, CDC has supported four provinces with the procurement of digital X-rays to enhance TB case finding among eligible PLHIV.

Laboratory strengthening

CDC and MOH continue to support and sustain laboratory diagnostic testing capacity. This includes support for:

24 viral load PCR laboratories.
Approximately 202 point-of-care testing platforms.
Over 200 hub facilities.

To ensure testing results are quality and accurate, CDC has supported the MOH to build a quality assurance coordination unit. This unit spearheads quality management system implementation and support to attain ISO 17043 accreditation. Currently, 11 laboratories have attained ISO 15189, with selected lower-level laboratories seeking national quality management system certification.

Electronic health record system

With PEPFAR funding, CDC has supported the development of the SmartCare National Electronic Health Record system. This system supports clinical service delivery and continuity of care in over 1600 high volume health facilities nationwide. The system has over 2 million enrolled and is used in health facilities providing care for >90% of PLHIV in Zambia. Data from SmartCare, logistics, laboratory, human resource, and health information systems feed into the national data warehouse for analysis and visualization.