President Edgar Lungu today, 11 December 32017, launched the Lusaka Anti Retroviral Therapy Saturation Surge Campaign. He launched the campaign during the commemoration of the World AIDS Day celebrations, whose theme is Ënding AIDS Starts with ME!”.
“This is the first ever surge campaign in Africa and I would urge everyone to support this campaign by getting tested now. If you are found negative, live responsibly and if found positive start treatment now immediately,” President Lungu said.
In his launch speech, President Lungu said “the commemoration of World AIDS Day this year coincides with the launch of the Lusaka Ant-retroviral Therapy Surge Campaign dubbed ‘Tiyende Pamodzi’’ . This campaign is aimed at Achieving HIV epidemic control, within one year, in Lusaka which currently carries 25 percent of the national HIV burden.”
President Lungu said, though Zambia has witnessed the decline of HIV cases, more work need to be done to sustain the gains achieved so far.
What is Lusaka ART Saturation Surge campaign?
Lusaka ART Saturation Surge Campaign is a strategy by the Ministry of Health and the United States President’s Emergency Plan for AIDS Relief (PEPFAR) in Zambia to achieve HIV epidemic control in Lusaka Province over 12 months, whereby 90% of People Living with HIV(PLHIV) are identified, 90% of identified PLHIV are placed on ART, 90% of PLHIV on ART become virally suppressed and use the information learned from achieving epidemic control in Lusaka Province to assure achieving 90-90-90 efficiently in Zambia nationwide by or before December 2020.
Currently, Lusaka province statistics indicate that out of an estimated population of 326,535 people living with HIV, only 71% of people are aware of their HIV status, while 88% are on treatment and 89% are virally suppressed.
CIDRZ, being the main GRZ partner in Lusaka will take a lead in ensuring that the objects, 90:90:90 are reached for Lusaka.
The Surge Strategies
The campaign will implement strategies such as increasing targeted case identification through index testing of family and other sexual partners (Partner Notification Services), different linkage strategies tailored for health facilities and communities, Implement the WHO recommendation to retest for verification HIV positive individuals prior to ART initiation and HIV self-testing to reach adolescents, men, and key populations.
Another strategy will be to increase physical infrastructure and staffing to provide ART for increased number of patients by procuring and erecting pre-fabricated structures and hiring additional staff at selected clinics. Convert selected health posts to ART sites by providing the required staff, ARVs and other health commodities, equipment and furniture for service delivery.
Expanding Differentiated Service Delivery (DSD) is another strategy that will be used to better serve the needs of patients on ART and reduce the workload of healthcare workers. This will be achieved through transfer of all stable patients into DSD programs to reduce the time and effort that they need to spend to receive care and treatment, which in turn should improve retention. Provide multiple months prescriptions of ARVs and 6-monthly clinical consultations for all stable patients in Lusaka to reduce the number of clinic visits.
In order to achieve the 3rd 90, viral load testing will be increased to assure that there is capacity to determine the viral load for all patients on ART. Lusaka Province, currently has three viral load testing labs namely the University Teaching Hospital, Pediatric Center of Excellence, and CIDRZ Central Lab with a collective capacity to process 100,000 viral load tests annually.
Lastly, the storage space for ARVs at the district and site levels will be increased to assure adequate supply for the increased number of patients and multiple months prescription, carefully forecast the supply needs at the site level and inform central medical stores to ensure timely drug distribution and ensure adequate supplies of HIV test kits, ARVs, EDTA test tubes, and viral load consumables at all times.
… and First Repoublican President, Dr Kenneth Kaunda was honoured by President Lungu for his efforts in fighting HIV in Zambia. President Kaunda will be one of the Ambassadors for the campaign. Others include Innocent Kalaluka a.k.a Smooth IK; award winning musician, B’Flow; and Keembe Member of Parliament, Hon. Princess Kasune Zulu.
“As we celebrate this day and in an effort of not leaving inmates behind by 2030, the following statistics are worth noting though not conclusive, 2451 inmates are on antiretroviral therapy,166 inmates are on TB treatment and 90% reduction in morbidity. We thank our cooperating partners such as CIDRZ for supporting this event and call upon all cooperating partners to continue with this collaboration if we are to end HIV/AIDS by 2030 without leaving the correctional community behind,” said Zambia Correctional Service (ZCS) Commissioner General Percy Chato.
This was during the ZCS commemoration of World AIDS Day at the Lusaka Central Correctional Facility.
“I wish to thank partners such as CIDRZ and those not mentioned here for supporting this event. our casual observation is that there is a decrease of HIV/AIDS among inmates and staff. However, we cannot rely on observations only. Therefore there is need for another scientific survey to determine the current prevalence rate in prisons as data from the 2013 survey could have been overtaken by time. We call upon all cooperating partners to conduct a survey in correctional facilities to depict a true picture of what is happening on the ground.”
Since its inception in 2001, CIDRZ has implemented 6 different projects in correctional facilities in partnership with the Government of the Republic of Zambia. These include:
- TB REACH 1 that was an implementations science programme that had both research and provision of TB/HIV interventions;
- Zambia Prisons Health Systems Strengthening (ZaPHSS) project whose goal was developing and building capacity of the prison health system that is able to plan, manage and implement improved health services in Zambian correctional facilities; This was with support from the European Union
- Placement of equipment such as GeneXpert and refurbishment of Mazabuka prisons health facility under the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and Centers for Disease Control CDC supported under the HIV Integration into Local Ownership (HILO) project;
- Treatment as Prevention (TasP);
- CONTINUUM study and
- The US government support Achieving HIV Epidemic Control (ACHIEVE) which is a five year project support by PEPFAR through the CDC partnership.
CIDRZ provided support for sustained TB diagnosis through support of back-up lab supplies, support of X-ray services and on-going training and mentorship of prison health centres.
CIDRZ Project Manager, Clement Moonga said “we value our relationship with ZCS and together we have been able to raise the standard of health care, particularly for HIV and TB, for inmates in Zambia. As a major technical partner to ZCS under projects such as TB REACH and the Zambia Prisons Health Systems Strengthening (ZaPHSS), we have been able to jointly establish policies and systems to improve access to healthcare in correctional facilities and structures for communication, coordination, and planning”.
Mapalo Chungu, a 14-year-old grade 9 pupil from David Kaunda Secondary School, was gripped with fears of menstruation when she first attended boarding school. There was basic knowledge of maintaining good menstrual hygiene practices at the school, and this always sent chills in her.
However, having the confidence to attend school all the time can make the difference between succeeding and dropping out for many adolescent girls. Thus, CIDRZ came up with a Menstrual Hygiene Management course and toolkit for teachers which is being used to educate pupils, both boys and girls.
While some people treated this opportunity with derision and opted out, curiosity got the better of Mapalo and she decided to attend. Today, she is an inspiration to many at her school.
MHM Crisis due to Lack of Knowledge
Mapalo confessed that at first, she was not comfortable going to school during her menstrual period days. Though she attended class despite the distress, many girls who lack knowledge of how to manage their menstruation are reported with recurrent absenteeism in school every month which subsequently affects their studies.
For, they would not even take part in extra-curricular activities, stay away from the playgrounds and never take part in outdoor activities during their menstrual days due to the possible embarrassment and the pain it brings.
The school matron in charge of the sick bay, Ms. Ikowa Ida, says,
“Previously, when the girls would stain themselves the boys would laugh at them. I used to find sanitary pads in the shower, on the soap racks, sometimes they would try to flush them down the toilets. It used to block somewhere then open on the other side of the fence. As a result, there would be infections that came because someone could not change the pad or dispose it in the right way.”
This poor sanitary condition contributed to dysentery, at some point in time, at David Kaunda National Technical School in Lusaka.
Introduction of MHM Toolkit brings revival
During the training, the facilitator taught on what menstruation is, the different cycles, what you use when you are undergoing this process and most important part of all was breaking the silent taboo of discussing the topic between boys and girls.
“They taught us how to be more open and free about the topic without having any feeling of regret, doubt or fear. I shared the information with my roommates and they were like, ‘Ah! The boys didn’t laugh and start making jokes when you were done?’ When I reassured them that was not the case, the next day I came with one, the next day another one, then the last day everyone came. They also appreciated the programme.”
Matron Ikowa also recalls,
“What we found very interesting and what was not there before is the involvement of boys. We found the teaching useful for everyone! The boys said they were going to help their sisters at home. The MHM toolkit has helped keep our environment clean. It has helped the first-time girls be aware of what is happening to them. The course has helped the big girls manage their menstrual cycle whether they have light or heavy flows. Apart from that, it has helped us know that when girls are on their menstrual they should not just rely on the sanitary pads that they buy in the shops. That they can also improvise using the washable pads that they were taught to make and use.”
The girls were also advised on precautionary measures to take the pain away such as taking warm water and painkillers that came along with the MHM toolkit supplies.
“I realised that there are people in boarding in similar situations who also go through menstruation and still manage to have a normal life. It shouldn’t be something that drags you down or affects other school programs. It prepares me for adult life and some other intense circumstances,” says Mapalo.
At the hostels, there has been a lot of change. There has been an improvement in the disposal of sanitary pads and general hygiene. Now the girls change their pads regularly and infections have reduced.
Preparing for a Hygienic Generation
Matron Ikowa says,
“I now freely talk about menstrual hygiene management regardless of who is there. I would recommend that it should be implemented in the school curriculum so that the children can grow up with it and the next generation can be better than ours.”
Today, Mapalo serves as an example to rest of the students. They started taking interest in maintaining the sanitary blocks and making the students aware of the best hygiene practices.