Country situational analysis [1]

Zambia’s first HIV infection case was reported in 1984. Since then, infection rates have increased rapidly with the adult HIV prevalence peaking in mid 1990s at about 16 per cent and then levelling off and stayed above 14 per cent ever since. Spectrum estimates of HIV prevalence among adults aged 15-49 years suggest that the Zambia HIV epidemic has been fairly stable over the last 15 years with a very modest decline after the initial peak prevalence.

According to the 2010 UNAIDS Report on the global AIDS epidemic, the national HIV prevalence in Zambia was 13.5% at the end of 2009. The report estimates that there were 980,000 people living with HIV in the same time period.

According to the 2007 Zambia Demographic Household Survey (ZDHS), 14.3 per cent of adults aged 15-49 years were HIV positive dropping by 1.3 per cent from the 15.6 per cent reported in ZDHS of 2001/2.

It is interesting to note that while HIV prevalence peaks among men aged 40 to 44 years old (24.1%), it is highest among women aged 30-34 (26%) [2].

According to UNAIDS, there were 283,863 people on antiretroviral treatment at the end of 2009, which corresponds to 64% of all those in need. The percentage of HIV positive pregnant women receiving antiretroviral treatment to prevent mother-to-child transmission was 69%.

Key elements of the national response

HIV and AIDS is the most serious threat to Zambia's development due to its influence on the country's most valued resources: young people, women and the workforce. Combined with its strong connection to the country's achievement of the Millennium Development Goals (MDGs), the Cooperating Partners (CPs) have deemed it necessary to place AIDS at the top of the development agenda in Zambia.

The Government of Zambia is a signatory to many international commitments related to HIV and AIDS. Among these is the Paris Declaration on Aid Effectiveness. This declaration identifies critical areas of action, and collaboration, by both Donors and partner country towards efforts in strengthening governance and improving overall development performance. These areas of respective action and collaboration include Ownership, Harmonization, Alignment, Results and Mutual Accountability. As part of the declaration, the 'Three Ones' principles were created to provide a framework for a National AIDS respons.

Zambia's national response to AIDS is articulated in the 2006-2010 National Strategic Plan.

Zambia has made strides towards mainstreaming gender into the national development process. A mix of policies and interventions that have mainstreamed gender and HIV and AIDS are in place. This includes the creation of an enabling policy environment and Institutional Framework on gender and HIV and AIDS. Examples include development and implementation of FNDP, Vision 2030, HIV and AIDS Policy 2005, Gender Policy 2006 and Population Policy 2007. More specific 'results' in relation to this area of endeavour need to be articulated.

Key achievements

• Development of the National HIV & AIDS Strategic Framework and Monitoring & Evaluation Plan 2006-2010
• Launch of the policy of providing free and universal access to antiretroviral treatment (ART) in 2003. By 2005 ART was available at 32 out of 34 public hospitals across the country. By 2007, it was available at all hospitals across the country and some clinics
• Increased availability of male condoms across the country
• Dramatic increase in the number of sites offering voluntary counselling and testing across the country.

Key challenges

• Weak infrastructure - unable to match the scale up of the provision of antiretroviral treatment
• Shortage of human resources
• Inadequate follow up of women after their first visit to PMTC clinics
• Limited accessibility of services in rural areas
• Limited access to infant diagnostic techniques
• Infant feeding practices do not seem to be well articulated by most health providers, resulting in sub-optimal feeding practices
• Drugs for opportunistic infections often out of stock

Useful links

• National Strategic Plan
• Zambia National HIV/AIDS/STI/TB Council
• HIV Prevention Strategy
• National AIDS Spending Assessment
• PMTCT and Paediatric Care and Treatment FactSheet
• 2010 UNGASS Report

Contacts

UNAIDS Country Office
P.O.BOX 31966
Lusaka, Zambia
Tel: +260 1 252645
Fax: +260 1 251214

Zambia National HIV/AIDS/STI/TB Council
Ben Chirwa
Director General
35 Independence Avenue
P.O. Box 38718
Lusaka, Zambia
Tel: +260 1255044/255092
Fax: +260 1 253881
Email: nacsec@nacsec.org.zm

Networks of organisations working on HIV

Zambian National AIDS Network (ZNAN)
Elizabeth Mataka
Executive Director
PO Box 32401
Lusaka, Zambia
Tel: +260- 1-256791/92/ 255969
Website: www.znan.org.zm
Email: znan@zamnet.zm

Networks of people living with HIV

Network of Zambiam Positive People (NZP+)
Clement Mfuzi
National Coordinator
PO Box 32717
Civic Center Building
Lusaka, Zambia
Email: napnzp@zamnet.zm

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1. All epidemiological data comes from the country's 2010 UNGASS Report, unless otherwise stated
2. Zambia Health and Demographic Suervey (ZDHS), 2007