Since 2002, CDC has been supporting the Rwandan Ministry of Health (MOH) in the areas of prevention of mother-to-child HIV transmission (PMTCT), HIV testing and counseling for general and key populations, antiretroviral therapy (ART), TB/HIV integration, blood safety, and laboratory and health workforce capacity building.
Strengthening Public Health Systems
CDC provides technical assistance to the MOH in the areas of facility-based clinical services, strategic information, public health laboratory strengthening, and human capacity development. With this support, the MOH provides comprehensive, integrated HIV clinical care and treatment services directly to the Rwandan population, serving approximately one-third of all Rwandan HIV patients eligible for treatment.
Strengthening Laboratory Systems
CDC builds the capacity of key reference laboratory functions in Rwanda, including laboratory diagnostics, quality management systems, and operational research. CDC helps develop in-country expertise for laboratory accreditation, strengthens lab infrastructure, and improves capacity at individual facilities for the delivery of high-quality clinical laboratory services.
Strengthening Surveillance and Health Information Systems
CDC supported the innovative use of cell phone and internet technology to develop a national HIV reporting system, which now includes integrated disease surveillance. CDC also contributes to the national e-Health strategy through support for health management information systems.
Key Activities and Accomplishments
CDC-Rwanda has helped strengthen the scope, quality, and sustainability of ART services. Rwanda has achieved one of the highest national ART coverage rates in sub-Saharan Africa, reaching an estimated 78.2% percent of those eligible for ART based on the new ART guidelines recommending ART initiation for PLHIV with <500 CD4 cells per mm3.
Through the leadership of the MOH and the technical and financial support of CDC, the availability of PMTCT services has increased significantly. As of June 2014, 97% (488/494 sites) of all health care facilities in Rwanda were providing PMTCT services. Among pregnant women attending antenatal care, the national acceptance rate for HIV testing was 98%. Program data shows the mother to child transmission rate at 18 months is 1.83%. This represents a significant reduction of HIV transmission from mother to child.
Over 80% of male partners who accompanied women to antenatal care services for PMTCT are also tested for HIV. Nationally, partner testing increased from 13% in 2003 to 85% in 2014. As of June 2014, 5269 discordant couples were enrolled in the follow-up program.
All health facilities that offer TB services provide directly observed TB treatment (DOTS). CDC also supports the scale-up of "one-stop" TB/HIV integrated services, which are now being offered at all 200 current Diagnostic and Treatment Centers in the country. TB treatment success rates have increased from 58 percent in 2003 to 89 percent in 2012.