PEPFAR Platform Accelerates COVID-19 Vaccination Uptake in Zambia

Community Health Worker, Esnart Mapulanga, during her community outreach for COVID-19 education in Chawama.

Zambia Ministry of Health, with support from the President’s Emergency Plan for AIDS Relief (PEPFAR) and the U.S. Centers for Disease Control and Prevention (CDC), integrated COVID-19 vaccination into HIV treatment centers to accelerate vaccine delivery as part of a national awareness campaign launched on World AIDS Day in December 2021. As a result, 70 percent of the eligible population received their COVID-19 vaccination – achieving the African Union Targets – just ten months after the campaign launch. The campaign demonstrates that HIV programs could be leveraged to increase COVID-19 vaccine coverage.

Challenges with Coverage

The scale-up of COVID-19 vaccination efforts across Africa has encountered challenges, including lower-than-forecasted vaccine donations, under-resourced health systems, difficulties reaching those unaccustomed to adult immunization programs, and vaccine misinformation. As a result, COVID-19 vaccine coverage remains low, with only 17 percent of people living in Africa being fully vaccinated as of May 1, 2022.

Turning the Tide in Zambia

A mother getting vaccinated at Chainda Clinic

COVID-19 vaccinations were first introduced in Zambia in April 2021, and coverage remained low. In December 2021, only 8.4 percent of the eligible population had received a COVID-19 vaccination. As vaccine supply began to increase, the government of Zambia, in collaboration with key partners, including PEPFAR and CDC, leveraged the national HIV program to enhance the COVID-19 vaccine campaign. By integrating COVID-19 vaccination into existing HIV programs, health teams could offer vaccine services to patients and their family members – rapidly increasing coverage. To further counter challenges, programs trained current health staff on offering vaccines while also encouraging staff to get vaccinated. Promotional materials for people living with HIV, who are at an increased risk for severe illness, were also created. Similar interventions were soon rapidly adapted and implemented across the country.

Launching the campaign on World AIDS Day, Zambia focused on the engagement of civil society leaders to help endorse vaccination and began to provide doses at the community level based on successful HIV programs. The impact was almost immediate, with daily vaccinations increasing from 3,713 per day before the campaign launch to 17,783 per day.

“The Government of Zambia, and partners, including CDC as part of the interagency health team, should be congratulated for this extraordinary achievement,” said CDC Country Director, Dr. Andrew Auld. “The Zambian government and partners have demonstrated that investments from PEPFAR in HIV services, civil society, and health systems can be leveraged to support response efforts and benefit other health priorities, including global health security.”

Striving for Health Security

CDC continues to advocate and implement scientifically based COVID-19 vaccination efforts, prioritizing individuals at high risk for severe COVID-19 and increasing booster dose coverage in Zambia. The national campaign continues to highlight the importance of community delivered vaccine services. By following Zambia’s successful service model, other countries may be able to hasten vaccination coverage and help reduce the risk of new COVID-19 variants, which can rapidly spread across the globe. By prioritizing health systems and security, a critical pillar of PEPFAR, CDC can help protect the health of individuals in the U.S. and beyond – ultimately saving lives.

COVID-19 Screening at the University of Zambia Teaching Hospital

CDC in Zambia

CDC established an office in Zambia in 2000 and works with various government ministries and provincial health offices to sustain a robust national HIV response. CDC’s areas of focus in its partnership with Zambia includes HIV prevention and treatment; integration of HIV and tuberculosis management; public health workforce capacity strengthening; and broader health systems strengthening, including disease surveillance, laboratory, and health information systems as well as the development of Zambia National Public Health Institute.