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Scaling Up Treatment in Zambia. Dr Susan Zimba – Tembo Professional Officer – WHO 1 st March 2013, Crest Golf Hotel. Background. HIV Prevalence 14.3% PLHIV 1.1 million
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Scaling Up Treatment in Zambia Dr Susan Zimba –Tembo Professional Officer – WHO 1st March 2013, Crest Golf Hotel
Background • HIV Prevalence 14.3% • PLHIV 1.1 million • Goal to expand the national response to mitigate the effects of HIV/AIDS and opportunistic infections, by improving access to quality care, treatment and support services • Programme based on WHO/UNAIDS treatment 2.0 principles
Guiding Principles • Five pillars • I – Optimize drug regimens • II – Promote diagnostics using point of care and other simplified technologies • III – Reduce costs • IV – Adapt delivery systems • V – Mobilize communities, protect human rights
Achievements • ART introduced in public sector in 2002 • Abolished user fees in 2004 • Rapid scale up 143 in 2003 to 344,000 • Coupled with increase in ART sites from 3 to 500 • Decentralised service delivery with task shifting • Making progress towards universal access 76.5% (2011)
8 million on ART by end 2011 …15 million is achievable ! 15.0 15 million 12.5 10.0 8 million 7.5 5.0 2.5 0.0 2002
Scale-up of ART, number of AIDS deaths and new HIV infections in LMIC*, 2001–2011
Impact of ART Scale up • Deaths due to AIDS were averted approximately 50, 000 lives saved in 2011 • Total death rate in adults declined from 1.02 percent in 2000 to 1.31 percent in 2011 • Total death rate among infants declined from 19 percent in 1997 to 5.3 percent in 2011 • For children aged 1-4 years the decline was from 17.1 percent in 1999 to 8.8 percent.
Challenges • Geographical and age disparities in ART coverage • Early infant diagnosis • Growing need especially with policy change- test and treat • Adherence and retention in care including emerging drug resistance • Point of care diagnostic services • Human resource
Conclusion • Universal access can be reached • Further scale-up must address disparities and inequities • With new evidence and new policies, the number of persons eligible for ART will increase • Forward-looking policies, more effective and innovative approaches, together with further investments • ARVs for treatment and prevention are a powerful tool towards ending the HIV epidemic