1. National ARV Program 2013
Dr Albert Mwango, BScHB, MBChB, MPH
National Antiretroviral Program
Coordinator
Ministry of Health, Zambia

2. 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

3. 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

4. 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

5. 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

6. 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

7. Epidemic among the children of
Zambia
Jul-13 7

8. 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
Inputandengagementfromkeystakeholders
Consultativeprocesswithpartners
Jul-13 8

9. 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

10. Focus for Year 1 (2014)
• Main Objectives
– Simplification, Harmonization and Integration of
HIV services in order to achieve overall objective
Jul-13 10

11. Q&A
Jul-13 11

12. Please contact:
Contact Information Here:
Thank you!