CIDRZ Internal Audit Department Providing Improved and Strengthened Programme Implementation

Thumbnail photo left:  Inonge Wambulawae, CIDRZ Chief Financial Officer and Zambian Accountant of the Year – 2014 delivering a talk “Auditing Third Party Risk – The Boards Perspective! at the Governance, Risk and Control – Adapting to Change Institute of Internal Auditors Zambia meeting recently.



Above from L: Emmanuel Lumbwe (Head of Audit Department), Emmanuel Chisongo, Nedson Theu, Elizabeth Makeche, Inonge Wambulawae (CFO) and Danny Sulwe

Internal Audit is an integral part of the CIDRZ programme management cycle with an expanded role to provide risk assessment and management as well as monitoring compliance to donor regulations and conditions.

Internal audit is not just about checking petty cash, but it is a function that helps review all aspects of a programme to achieve better results and ensure value for money considering that we use donor conditional grants that need to be reported against,” says Mr. Emmanuel Lumbwe, Head of Internal Audit.

We are not the Police, we are Partners

The Internal Audit function at CIDRZ draws its mandate from the organisation’s Audit Charter and has control over internal audit, compliance, governance and other associated systems and reports directly to the Audit Committee, a subcommittee within the Board of Directors. “We normally conduct annual risk assessments which are ranked in hierarchical order. We then engage with the programme staff to see how we can avert or minimise risk likelihood and impact; this is what drives our risk plan for the year.”

I am aware that internal audit has been viewed as a ‘police’ but it shouldn’t be like that, we are partners in fulfilling our mandate as CIDRZ. That’s why we engage our colleagues in programmes to see how best we can achieve our results while complying to set standards and procedures,” Mr. Lumbwe adds.

Maturing in Risk Management

Over the past few years, CIDRZ has worked towards strengthening the internal audit function within the organisation. Among the interventions implemented include the establishment of the Audit Committee within the Board as well as the Risk Management Committee within the CIDRZ management structure, with the latter also tasked with capacity-building of staff in internal audit.

Much of the recent funding into CIDRZ has been coming because of the confidence donors have in the improved and strengthened Audit systems.  I am proud to say that CIDRZ is maturing in risk management and we are proud of that achievement,” notes Mr. Lumbwe.

CIDRZ Internal Audit Keeping up with Modern Trends

With risk management being dynamic, all five members of the CIDRZ Internal Audit team are members of the Institute of Internal Auditors Zambia (IIA-Z), a national body that provides training and guidance on best practices. Recently, the CIDRZ Internal Audit team attended a two-day conference organised by the IIA-Z in Livingstone, Zambia which focused on Governance, Risk and Control – Adapting to Change.

It’s always important for internal auditors to be abreast with the current trends so they can know how best to serve their organisations,” added Nedson Theu, an Internal Auditor at CIDRZ.

During the Conference, CIDRZ’s Chief Financial Officer and also 2014 Zambian Accountant of the Year, Inonge Wambulawae was a key speaker and presented on Auditing Third Party Risk – The Boards Perspective!

CIDRZ Celebrates Chawama Level 1 Hospital Refurbished Laboratory



24th September was an important day for CIDRZ as we celebrated the achievement of handing over the refurbished Chawama laboratory infrastructure to the government of Zambia at a colourful event attended by key Ministry and partner VIPs.

The funding for the refurbished lab was generously provided by the US government through the PEPFAR/CDC transition to local ownership HIV Integration to Local Ownership (HILO) project.

The lab is now one of the largest in the district and able to perform all required testing for new anti-retroviral (ART) program clients on-site rather than transporting specimens to another lab incurring delays in clinicians receiving important test results and clients receiving the ART care they require. CIDRZ Lab Technical Mentors will continue to assist with training and systems development until all lab personnel have the requisite skills and a steady supply of reagents so that they may take over the testing for all clients enrolled in the HIV Care and Treatment program at Chawama.

Speeches were delivered by the District Medical Officer Dr Gideon Zulu, CIDRZ CEO Dr Charles Holmes, CDC Country Director Dr Jim McAuley, and Provincial Clinical Care Specialist Dr Wajirovya Chilambo, all followed by a vote of thanks by the Chawama Nursing Officer in charge.

There was drumming, there was dancing, speeches, a ribbon-cutting ceremony and a  tour of the refurbished lab.

CEO Holmes Speech at the Official Opening of the Refurbished Chawama Clinic Lab

Photo Front Row L to R: Deputy Director Lab Services MOH Dr David Nsama, Dr Charles Holmes, Provincial Principal Clinical Care Specialist Dr Wajirovya Chilambo, Country Director CDC Dr Jim McAuley, District Medical Officer Dr Gideon Zulu

Official Handover of the Refurbished Laboratory of the Chawama Level One Hospital

24th September 2015

It gives me great pleasure to join you today as the Centre for Infectious Disease Research in Zambia – CIDRZ – joins with the United States Government represented by the Country Director of the Centers for Disease Control and Prevention Dr Jim McAuley, as we officially handover the refurbished laboratory to the Zambian Government through the Chawama First Level Hospital. This momentous event could not take place without the contributions and support for Zambia generously received from the United States and the solid partnership we have established with the Government of Zambia.

CIDRZ was established as collaboration between the University of Zambia, the University of Alabama, and the then Director of the Lusaka District Health Management Board, Dr. Moses Sinkala. CIDRZ became an independent Zambian non-governmental organisation in 2011, with assistance from the CDC and other organisations, and has a mission of supporting health program implementation, conducting locally-relevant research, and to serve as a resource for training the next generation of public health and research leaders locally. I am happy to say that each of the three legs of our mission are thriving and resting on a firm foundation of management practices and governance. Most importantly, all of this work is done with the closest collaboration with our colleagues in the Government of the Republic of Zambia, whose lead we take, and whose vision for a healthier Zambia we share.

A key interest of CIDRZ is to support the Zambian Governments’ efforts to strengthen healthcare training and systems so that high-quality clinical healthcare is available to ALL Zambians as stated in our Vision of  “a Zambia, and a region, in which all people have access to quality healthcare and enjoy the best possible health, including a life free from AIDS.

However, high-quality healthcare is not possible without high-quality laboratory testing services. Clinical laboratories are sophisticated and complicated environments and require sufficient space, light and infrastructure, specialized laboratory personnel and well-functioning and validated instruments, and a robust supply chain. When a patient agrees to having a blood test they do so with trust; they trust that their specimen will be treated carefully and seriously – that the laboratory specialist will quickly perform the correct testing so that an accurate and trustworthy result is provided to the clinician. The result of a single blood test can change a life and it is of utmost importance that the laboratory result is one that can be trusted, and that it is provided in as fast a time as possible. That is our challenge and our opportunity as we all support this work.

In 2014, the Government of the Republic of Zambia – as part of their ongoing support for improved maternal and child health services – constructed a new maternity wing to accommodate the growing population of Chawama. Chawama Hospital Management then approached CIDRZ and requested for assistance in renovating and refurbishing the old labour ward into a new and larger laboratory so as to increase testing space and overall lab capacity. With generous funding received from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC), CIDRZ has been proud to contribute to this exercise so that now the Chawama First Level Hospital has a spacious clinical laboratory to better serve the local community.

Important work to refurbish existing infrastructure to provide the needed services such as this was made possible because it is part of the United States Governments’ CDC and PEPFAR program transition to local Zambian ownership. The refurbished laboratory that we will officially open today is a success story of collaboration and development, and heralds other similar transition work that is currently taking place – again through support of the U.S. government – at other CIDRZ-supported Government of the Republic of Zambia health facilities in Eastern, Western, Southern and Lusaka Province. In addition I would like to commend the work of CIDRZ colleagues Mpande Mwenechanya, Bernadette Nyemba, Mabvuto Phiri and Vina Chilengi who made this lab transition and this opening event today possible.

As is usual practice during any laboratory transition activity, the CIDRZ Lab Technical Mentors assist with training and systems, and will continue to support the Chawama Laboratory staff until all are comfortable with the requisite testing skills and there is a constant availability of reagents to ensure a seamless lab service to the community. Even after full transition to Chawama, CIDRZ will be available to provide technical support if, and as, necessary.

Prior to this refurbishment, the Chawama Health Centre laboratory was small and cramped, and samples from this populated community had to be transported across the city for testing at the CIDRZ Central Lab in Kalingalinga.

But now, with the refurbished laboratory, the Chawama Level One Hospital Lab personnel are able to perform on-site testing for haematology and chemistry and provide these results to patients, as well as CD4 T-cell count assays for new anti-retroviral treatment (ART) patient enrollees.

While laboratory personnel are perhaps less visible to the general public, and even to those that attend a health centre, we must all recognize that the work they do is crucial to the correct detection, diagnosis and treatment of disease. High-quality laboratory services are therefore a core pillar in the Zambian HIV/AIDS response.

I am pleased that CIDRZ has been able to play a role in the development of the Chawama Laboratory so that it is now becoming one of the largest Level 1 facility labs in the district. It will not only have the capacity to perform all laboratory testing on-site, but in the near future will have the capacity to even serve as a referral lab for other health centers in the District.

This is an exciting day and I am pleased that CIDRZ can be part of the country’s efforts to promote quality health care, including laboratory services. I applaud the Zambian and the United States governments and the other supporting partners many of whom are here today that made this success, and will make future successes possible as we continue to work together to fulfil our vision of bringing quality healthcare to all Zambians.

Thank you.

Dr Charles Holmes MD, MPH

CIDRZ Director and Chief Executive Officer

CIDRZ Lab Hosts Ministry of Health Director of Disease Surveillance, Control and Research



Last Friday, 18th September, CIDRZ was honoured to host a visit from the Ministry of Health Director of Disease Surveillance, Control and Research, Dr Elizabeth Chizema. Dr Chizema and MOH Senior Research Associates, Mwiche Siame and Doris Osei Afriyie, met with CEO Dr Charles Holmes, Dr Roma Chilengi, Dr Carolyn Bolton, Obert Kachuwaire  and other key CIDRZ research and science staff as they toured the CIDRZ Central Lab in Kalingalinga and the Chainda South Clinic in Kalikiliki.The CIDRZ Central Lab tour was given by Lab Managers Mabvuto Phiri and Kaunda Kaunda, and the Chainda South Microlab tour was given by Michelo Simuyandi. This visit was the first time that CIDRZ hosted such key ministry representatives to the state-of-the-art CIDRZ Lab.



This week CIDRZ hosted special guests from the United States National Institutes of Health (NIH) Division of AIDS (DAIDS) Office of Clinical Site Oversight (OCSO) and the University of Alabama at Birmingham (UAB) who came to visit our clinical research sites and meet the teams as well as pay a courtesy call to the Ministry of Health Directorate of Disease Surveillance, Control and Research.

Here they are visiting the HIV Vaccine research team at the Matero Reference research clinic From left: Helen Mulenga CIDRZ Head Pharmaceutical Services, Manizhe Payton OCSO Director, Mary Kirker Director NIH Grants Management Program, Dr Carolyn Bolton CIDRZ Chief Medical Officer, Hope Mwanyungwi CIDRZ Head Research Operations, Fatima Ravat OCSO Project Officer of the Alabama Clinical Trials Unit (CTU) and Clinical Research Sites (CRSs), Agnes Nondo, CIDRZ Study Coordinator, Christine Namakobo CIDRZ Senior Research Nurse, Dr Mwangelwa Mubiana-Mbewe, CIDRZ Director Paediatric HIV and PMTCT, and Kim Cooper Grants Management Specialist, Alabama CTU and CRSs.

CIDRZ presents at 9th European Congress on Tropical Medicine and International Health


Clement Moonga, Programme Manager for our European Union-funded Zambian Prisons Health Systems Strengthening (ZaPHSS) project, made two presentations at the 9th European Congress on Tropical Medicine and International Health in Basel, Switzerland which took place under the theme: Driving the Best Science to Meet Global Health Challenges.

The abstracts presented reflected qualitative work done with CIDRZ and Zambian Prisons Services colleagues to better understand structural factors that influence the health status of incarcerated persons in Zambia:

‘Prison Food Provisions, Family Support and Vulnerability to Health Risks in Zambia’

‘Structural Drivers of Inequality in the Zambian Prison Health System’

Key note speaker at the conference was the Zambian Minister of Gender, Professor Nkandu Luo, who spoke about Health Challenges in Africa. Honourable Minister Professor Luo was representing the Zambian Coalition of African Parliamentarians against HIV/AIDS (CAPAH).

The European-Union, the Ministry of Health, the Ministry of Home Affairs and CIDRZ recently signed a Memorandum of Understanding and officially launched the Zambian Prison Health Systems Strengthening Framework.

CIDRZ Contributes to Formative Research about HIV self-testing in Zambia


Photo L to R: Annette Brown, Deputy Director International Initiative for Impact Evaluation (3ie), Jenala Chipungu, Roma Chilengi, and Arianna Zanolini of CIDRZ

On 12th August CIDRZ researchers Arianna Zanolini, Jenala Chipungu and Roma Chilengi disseminated results of the Phase 1 formative research study assessing the feasibility and acceptability of oral HIV self-testing in Zambia to the Ministry of Health, Ministry of Community Development Mother and Child Health and other key stakeholders.

Given the low uptake of HIV Counselling and Testing (HCT) services, Zambia is considering adopting the use of HIV self-testing (HIVST) to increase HIV status awareness, especially among those difficult to reach through traditional testing models. Formative research work was required before developing policies and considering rolling out the technology.

The goal of this mixed methods survey and qualitative study was to investigate whether self-testing would be an acceptable and effective innovation for HCT in Zambia and to provide guidance on optimal ways to implement self-testing.

The study funded by 3ie – International Initiative for Impact Evaluation was conducted in
17 areas within Lusaka Province and a total of 1,617 participants, aged between 16 and 49 years of age took part in either a household survey, focus group discussion or
key informant interview

The study found that HIV self-testing was feasible and acceptable and has the potential to reach non-testers, but that further formative research needs to be done to better understand important issues such as related counselling needs; distribution location and cost; linkages to care; effective method to inform illiterate or physically-challenged populations how to perform the test and interpret results; and whether the test roll-out should only be targeted on key populations.  Further research work on the topic is planned.

CIDRZ Welcomes 2015-16 HealthCorps Fellows



Photo  Some of our 2015-16 CIDRZ HealthCorps Fellows! From L to R: Lisa Chileshe, Benjamin Usadi, Katayi Kazimbaya-Mwila, Emilie Efronsom, Njinga Kankinza, Kalo Musukuma, and Dr Roma Chilengi CIDRZ Chief Scientific Officer.

Introducing the 2015-16 CIDRZ HealthCorps Fellows

In 2004, CIDRZ initiated a public health fellowship programme, HIVCorps, to provide future Zambian and international public health leaders exposure to public health-related programme implementation in the Zambian setting. Fellows honed their project management skills as they provided logistical support to designated CIDRZ HIV-related service projects. Entrance to the fellowship  is competitive and since inception over 104 fellows have taken part and gone on to progress in their careers, both locally and abroad.

In 2014 we changed the fellowship name to HEALTHCorps to better reflect our expanding and updated programme focus – mitigating HIV/AIDS still remains a prominent feature of our work – but we also work to improve overall health systems to better deliver on our vision of “A Zambia and a region in which all people have access to quality healthcare and enjoy the best possible health, including a life free of AIDS.”

This year we received 244 competitive applications, and after careful review have chosen 8 fellows, 1 junior fellow and 1 volunteer. Each will be attached to a designated project and have clear deliverables to accomplish. Six of the successful candidates are Zambian, 3 are from the USA and one from Australia.

Katayi Kazimbaya-Mwila MSc, BSc
Katayi has a Masters degree in Biochemistry from Rhodes University, South Africa and she will contribute her efforts to the Bill & Melinda Gates-funded Rotavirus Vaccine Effectiveness study, ROVAS.

Chishimba Katema BSc, MSc
Chishimba has a Masters degree in Molecular Biology from  Kazan State University, Russian Federation. He will be attached to the ROVAS study as a volunteer.

Njinga Kankinza MSc, BSc
Njinga has a Masters degree in Clinical Linguistics from Potsdam University, Germany and she will contribute her efforts to the Bill & Melinda Gates-funded Community ART study.

Emilie Efronson MPH, BA
Emilie has a Masters of Public Health degree in Global Health from Boston University, USA. She will also be attached to the Community ART Study.

Natasha Laban BSc
Natasha has a Bachelors degree in  Molecular Biology and Genetics from the University of Zambia and she will contribute efforts to the PEPFAR/CDC-funded HIV Integration Local Ownership (HILO) project.

Kalo Musukuma BSc
Kalo has a Bachelors degree in Molecular Biology and Genetics and is studying for her Masters degree in the same at the University of Zambia. She will contribute her efforts to the Bill & Melinda Gates-funded Better Information for Health in Zambia study.

Kelsi Mowreader BS
Kelsi has a Bachelors Degree in Public Health from Oregon State University and is studying for a Masters of Public Health in Global Heath. She will also be attached to the BetterInfo Study.

Lisa Chileshe BA
Lisa has a Bachelors degree in Psychology, Health Sciences, and Counseling from Nelson Mandela Metropolitan University, South Africa. Lisa joins as a Junior Fellow and she will be contributing efforts to the Better Health Outcomes Through and Mentorship (BHOMA) project.

Benjamin Usadi MPH, BA
Benjamin has a Masters degree in Epidemiology/Biostatistics from the University of California, Berkeley, will be attached to the CIDRZ Analysis Unit.

Helene  Smith MPH, BA
Helene has a Masters of Public Health degree in International Public Health from the University of Sydney, Australia. She will be attached to the TB Department and will contribute efforts to the Treatment as Prevention study.



Dr Akwi Asombang, Assistant Professor of Medicine University of Missouri presents at CIDRZ Research Rounds


Dr Akwi Asombang, Assistant Professor of Clinical Medicine in the Division of Gastroenterology/Hepatology at the University of Missouri – Columbia School of Medicine in the U.S. presented her research results at the CIDRZ Research meeting on 27th August.

Dr Asombang is a recipient of an American College of Gastroenterology International training grant and has completed research at the Cancer Diseases Hospital evaluating trends of pancreatic and colorectal cancer. She presented a talk entitled “Descriptive analysis and trends of pancreatic and colorectal cancer at the Cancer Diseases Hospital Zambia”.

Dr Asombang  completed a combined Internal Medicine – Paediatric Residency at Saint Louis University School of Medicine/Cardinal Glennon Children’s Hospital and an Adult Gastroenterology/Hepatology Fellowship at Washington University School of Medicine, St. Louis. She also has an Masters of Public Health degree earned from Saint Louis University School of Public Health and is a Fogarty Fellow alumni who completed her gastric cancer research at the University Teaching Hospital in Lusaka in 2012.