Country Situation Analysis

UN Support to the National Response

Contacts

UNAIDS Global Report 2006 Data

Country Situation Analysis

The devastating human and developmental impacts of the AIDS pandemic remain among the most formidable challenges impeding the realization of Zambia’s development aspirations. In terms of the human face of the crisis, from the Zambia Demographic and Health Survey 2002, it is estimated that one in six Zambians aged between 15 and 49 years are infected with HIV, while more than four times more girls aged 15–24 years are infected than their male counterparts, pointing to the feminization of the pandemic. Women and girls thus constitute a major vulnerable group. Other vulnerable groups include commercial sex workers, mongers, truck drivers, men in uniform, prison inmates, migrant workers and fishermen.

More recent data from the 2004 Sentinel Surveillance survey indicate that the overall HIV prevalence level of all pregnant women aged 15–49 years from the 23 sentinel surveillance sites tracked in 2004 was 18.7%. The mean HIV prevalence level at the urban sites was 25% and 11.8% for rural sites. HIV prevalence among 15–19-year-olds at the sentinel sites was 11.6%, 8.7% for rural sites and 14.6% for urban sites.

The country is deeply affected by HIV socially and economically and will continue to be so for many years to come. About one million Zambians are estimated to be living with HIV; 200 000 are in need of antiretroviral therapy. The AIDS epidemic is estimated to have resulted in over one million orphans. It has also been estimated that AIDS morbidity and mortality has resulted in about 50% of general hospital admissions and over 70% of medical hospital admissions.

However, Zambia is striving to gain control over the spread of HIV and to treat and care and support those infected and affected. A number of support structures aiming at planning and coordinating the multisectoral response to the epidemic have been out of place. The National AIDS Strategic Plan 2002–2005 developed by the National AIDS Council provides guidance on national priorities. A national antiretroviral treatment programme has been implemented and is now providing free antiretrovirals to all those who need it. As of end November 2005, an estimated 43 964 people living with HIV were accessing antiretroviral drugs through 53 public sector sites throughout the country. As a signatory to the UNGASS Declaration of Commitment, Zambia has made some headway in keeping some of the promises made. The Joint Annual Programme Reviews (2004 and 2005) have indicated that there is need for scaling up implementation of all interventions and across the country with the greater involvement of civil society, especially people living with HIV.

Challenges

• Human resource capacity constraints—leading to poor implementation especially in the rural areas of the country. This has led to inequitable distribution of service delivery including with regards to antiretroviral services. High attrition rates and a previous public sector wage cap are key factors.
• Coordination capacity of the National AIDS Council—although this has improved significantly due to the presence of a substantive Director General, the capacity to carry out some of the core functions remains weak.
• Mainstreaming of AIDS or integration of AIDS in sectors other than health forms a key area of support defined in the new National AIDS Strategic Framework 2006–2010.
• Intensifying HIV prevention is a key area of support that the country has embarked on for 2006. Support is required to scale up the Behaviour Change Communication activities and to develop some accountability around some of the proposed actions.
• Scaling up the decentralized response remains a key challenge.
• Civil society empowerment.

UN Support to the National Response

• Support to the development of the 5th National Development Plan and the 3rd UNDAF 2007–2010—the UN Country Team discontinued the formal preparations of the 3rd Country Coordinating Mechanism for Zambia, in preference for working within and supporting the National Development Plan process. The UN Country Team was particularly interested in ensuring that UN fundamentals—Millennium Development Goals, rights-based programming and results based management—were fully integrated in the NDP process. The definition of the next UN Development Assistance Framework 2007–2010 took place with HIV and AIDS forming the main pillar.
• Support to the National AIDS Council—financial, logistical, technical and administrative support. UN Volunteers in all districts to support the coordination of a multisectoral response on AIDS; monitoring and evaluation adviser in the National AIDS Council.
• Strategic information on the country situation and response provided—workplace policy study; National Composite Policy Index study; impact assessments on the health, education and agricultural sectors;
• Support to the scale-up of the national antiretroviral treatment plan
• national orphans and vulnerable children action plan supported;
• mitigation framework of the agricultural sector supported;
• preventive care services for refugees availed and integrated into national services;
• national policy on HIV in the world of work for both public and private sectors and the informal economies developed and implementation supported;
• technical support to uniformed services provided; and
• advocacy and media engagement.

Support to the national strategic planning and review process—with a focus on the decentralized levels. The Joint Annual Programme Review 2004 was conducted with full support for the UN agencies. Support to key civil society organizations—capacity development of the Network of Zambians living with HIV and AIDS (NZP+) and others.

Support to the monitoring and evaluation system—at decentralized levels including installation of Country Response Information System and its utilization in collecting data for the Zambia UNGASS 2005 report.

Objectives

• Support the National AIDS Strategic Framework that will guide efforts of all stakeholders—the costing of the framework, an action plan for 2006 developed, mainstreaming of AIDS and gender in the implementation of the framework supported.
• Support National AIDS Council at all levels—specifically its governance capacity and the provincial and district level institutions; the Partnership forum and the Country Coordinating Mechanism.
• Monitoring and evaluation framework supported the operationalization and decentralization of the completed framework and improved the resource tracking capacity of the National AIDS Council, linked to existing systems.
• Strategic information on the country situation and response provided—the Demographic and Health Survey, the UNGASS and universal access reports.
• Support the increase in access to comprehensive prevention services—a national prevention strategy, scale-up of prevention of mother-to-child transmission and condom programming support.
• Support the increase in access for treatment, care and support—focus on children.
• Provide technical support to the public sector on AIDS impact.
• Strengthen the institutional capacity to mitigate the socioeconomic impact for people infected and affected by HIV.

Contacts

Stella Anyangwe
Chair, UN Theme Group on HIV/AIDS
(WHO Representative)
Andrew Mwenya/Beit Road
Plot #4609
Rhodes Park
P.O. Box 32346
Lusaka, Zambia
Tel: 260 1 255 322
Fax: 260 1 252 863
Email: onyanin@worldbank.org

UNAIDS Country Coordinator
Catherine Sozi
Telephone: +260 1 252 645
Fax: +260 1 261214 / 251214
Postal address:
UN Annex, Andrew Mwenya/Beit Road
PO Box 31966
Rhodes Park, Lusaka, Zambia
Email: sozic@zm.afro.who.int

NAC
Ben Chirwa
Director General
35 Independence Avenue
P.O. Box 38718
Lusaka, Zambia
Tel: +260 1255044/255092
Fax: +260 1 253881
Email: aidsec@zamnet.zm

Networks of organisations working on HIV
ZNAN
Elizabeth Mataka
Executive Director
PO Box 32401
Lusaka, Zambia

Networks of people living with HIV
NZP+
Clement Mfuzi
National Coordinator
PO Box 32717
Civic Center Building
Lusaka, Zambia

UNAIDS Global Report 2006 Data

Country profiles provide key information on the status-quo of the HIV pandemic in the countries of the region. Data is updated by the UNAIDS Country Offices on a yearly basis.