National ARV Program 2013

Dr Albert Mwango, BScHB, MBChB, MPH

National Antiretroviral Program Coordinator

Ministry of Health, Zambia

Background: HIV in Zambia

• Zambia has a population of 13 million

• HIV Prevalence in adults: – 15.6% (2002 ZDHS), now

14.3% (2007 ZDHS)

– Rural 10.3 % – Urban 19.7%

ZDHS 2007

Jul-13 2

Background: HIV in Zambia

• new infections rate in 2011 – 0.96% among males – 1.25% among females

• Eligible and on ART – 480,000 (Adult coverage

- 88%) – 34,000 (Children

coverage 34%)

– 31% access services in rural sites

MOH 2012 report

Jul-13 3

Epidemic among the women of Zambia (i)

• HIV prevalence (2007) – Adults (ages 15-49)

14.3%

– Women (ages 15-49) 16.2%

– Pregnant women 16.4%

• HIV+ Pregnant women (2012) – 87,272

ZDHS 2007

Jul-13 4

Epidemic among the women of Zambia (ii)

• ANC attendance – 93.7% of pregnant

women attend ANC at least once • 19.2% in 1st Trimester

– 60.3% attend ≥  4  visits – 98.9% Counseled &

tested for HIV – 47% deliver at health

facilities ZDHS 2007

Jul-13 5

Epidemic among the women of Zambia (iii)

• eMTCT coverage – 100% (124) of districts – 64% (1,200) of sites – 88.6% HIV + ♀ given

prophylaxis

• Policy  in  place  (Jan  ‘13)   – Lifelong triple cART for

all HIV+ Pregnant women

– Primary Regimen: TDF/FTC/EFV

MOH report 2012

Jul-13 6

Epidemic among the children of Zambia

Jul-13 7

Road map for the Option B+ policy

2013 Q3-4 Implementation

Site assessment “tools”  development Site activation

2013 Q1-2 policy adoption

Policy adoption Stakeholder consultations Resource mobilization Development of

implementation plan

2012 policy justification

Business case under reviewed by MOH senior management

Further discussion and presentations by ARV Program

office

Senior management to present to policy makers

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Program Focus: Three Years

Year Program Focus

Year 1 (2014) a. Roll out of New Guidelines including option B+ b. Set up HIV Drug resistance surveillance protocols c. Expansion  of  3I’s  (TB/HIV  interventions) d. Ensure Commodity Security e. Expansion of Advanced Treatment Centers

Year 2 (2015) a. Expand HIV Drug resistance surveillance activities b. Enhance Information Systems (SmartCare) c. Expansion  of  3I’s  (TB/HIV  interventions) d. Ensure Commodity Security

Year 3 (2016) a. Expand Universal Access: Test and treat b. Enhanced Patient retention systems c. Promote robust M&E Systems

Jul-13 9

Focus for Year 1 (2014)

• Main Objectives – Simplification, Harmonization and Integration of

HIV services in order to achieve overall objective

Jul-13 10

Q&A

Jul-13 11

Please contact:

Contact Information Here:

Thank you!