CDC in Zambia

Overview

Since 2000, CDC has worked with the Zambia Ministry of Health (MOH), Zambia National Public Health Institute (ZNPHI), provincial health offices, and partner organizations to address the following public health areas:

• Workforce development
• Emergency response
• Health systems strengthening
• HIV and TB
• Non-communicable diseases
• Malaria

Global health security

Strategic focus

CDC's global health security work in Zambia focuses on strengthening the country's public health systems across the following core areas:

Public health systems

CDC supports public health systems strengthening in Zambia by engaging in:

• Enhancement of epidemiology, disease surveillance, program monitoring, and health information systems such as the supporting the development of SmartCare, a national EMR system for clinical care and continuity, providing confidential records.
• Establishment and continued support of the Zambia NPHI to strengthen public health surveillance and the capacities to detect and respond to health threats and serve as an NPHI Center of Excellence, supporting other NPHIs in the region.
• Evaluations to assess program impact and inform rapid adjustments to address the evolving HIV epidemic.
• Support of the Government of Zambia to lead public health responses.
• Support of local organizations to provide health services at the national and community level.

Workforce development

CDC supports training scientists through the Field Epidemiology Training Program (FETP), established in Zambia in 2014. FETP trains epidemiologists to perform disease surveillance and contain outbreaks of diseases like HIV, tuberculosis, cholera, polio and COVID-19. Participants learn critical skills for data collection and analysis and using data to inform action.

CDC also supports the expansion of academic and clinical training programs in the University of Zambia and the University Teaching Hospital and the use of the ECHO (Extension for Community Healthcare Outcomes) platform to enhance training and mentorship.

Emergency response

CDC works to strengthen the capacity of Zambia's emergency response. During the COVID-19 pandemic, CDC Zambia supported vaccination campaigns, disease surveillance strategy, and contact tracing, leveraging the existing laboratory network as the backbone of the COVID-19 laboratory network. This allowed for the development of:

• COVID-19 clinical guidelines for case management
• Health informatics
• Science-based public health communication for Zambians
• Epidemiologic studies

Key achievements

• Over 95% of people on antiretroviral therapy (ART) have an electronic health record.
• 54 Zambians completed the two-year Advanced FETP and 320 completed the three-month Frontline FETP since 2016.
• In just four years, the Extension for Community Health Outcomes (ECHO) program expanded to 367 health facilities across all of Zambia's 10 provinces.
• CDC helped train more than 500 public health workers and more than 1,000 clinicians in COVID-19 prevention, response, mitigation, and management.

HIV and TB

Strategic focus

Through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), CDC works with Zambia to build a sustainable, high-impact national HIV and TB response to accelerate progress toward epidemic control. CDC efforts include:

• Supporting the implementation of key HIV programs to reduce new infections and HIV-related deaths in Lusaka and Southern, Eastern, and Western provinces.
• Increasing access to evidence-based high-impact combination prevention and improving the quality and sustainability of HIV services.
• Supporting Zambia in achieving the UNAIDS 95:95:95 targets by 2030.
• Integrating HIV and TB case management.
• Supporting the MOH to enhance TB testing platforms to increase access of TB Preventive Therapy (TPT) for people living with HIV.

Key achievements

• With CDC support and strengthened laboratory infrastructure, the MOH doubled the number of HIV viral load tests performed to approximately one million tests per year.
• As of September 2023, 93% of people living with HIV in Zambia were on ART and viral load suppression among this group was more than 95%.
• More than 1.5 million medical male circumcisions were performed in PEPFAR-supported regions as of February 2022.
• 88% of the HIV positive recipients of care were screened for TB in 2021.

Non-communicable diseases

Strategic focus

Women living with HIV experience increased risk of human papillomavirus (HPV) and cervical cancer. Before the introduction of ART, women living with HIV were not screened for cervical cancer. With CDC support, Zambia launched a long-term, culturally appropriate, community-based training program in community health promotion to address cervical cancer.

Through PEPFAR, CDC also provides policy and clinical guidance for integration of non-communicable disease management including hypertension, diabetes, mental health, and other comorbidities for people living with HIV.

Key achievements

• As of September 2023, cervical cancer screening services are available in nearly 1,311 of the 2,019 health facilities across the country, which represents 65% screening coverage.
• More than 850,000 women were screened for cervical cancer in 2021.
• More than 924,000 adolescent girls have been fully vaccinated against HPV in Zambia since 2018.

Malaria

Strategic focus

Under the U.S. President's Malaria Initiative (PMI), CDC assigned a resident advisor to the malaria-endemic country of Zambia to support implementation of malaria prevention and control activities. CDC contributes to the development and monitoring and evaluation of activities, including:

• Providing long-lasting insecticide-treated nets and indoor residual spraying
• Preventing malaria in pregnancy
• Enhancing diagnostics and case management

Key achievements

• CDC supported implementation of the 2018 and 2021 Malaria Indicator Surveys.
• CDC supported development and implementation of a national insecticide resistance-monitoring program since 2006.

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