Zambia – FY 2010 Approved Funding by Program Area, Agency and Funding Source*
*Only appropriations from the GHCS (State) fund account are notified by the Global AIDS Coordinator.
With strong linkages to education, workplace programs, and other health programs (including malaria), the PEPFAR program embodies a multi-sectoral response to a disease that affects all sectors of society. This, combined with dramatic improvements to laboratory capacity, commodity and procurement systems, and health records management, speaks to the PEPFAR program’s commitment to health systems strengthening and linkages with development in its HIV response. Preventing new infections, addressing human and financial resource gaps, and building sustainable local public and civil society entities will be a focus of the next five years of the PEPFAR program. In the next year, the Zambia Mission will work with the Government of the Republic of Zambia (GRZ) and other donors in Zambia to develop the National AIDS Strategic Framework (NASF), which will also provide structure for a Partnership Framework. The Zambia mission has helped coordinate efforts between the GRZ and Cooperating Partners (donors) towards the next NASF and the PF and has engaged cost modelers to conduct an assessment of the ARV costs in preparation for the PF. The development of the PF is underway and slated for completion by the fourth quarter in fiscal year 2010.
PEPFAR HIV prevention programs have contributed to an increase in the age of sexual debut, a reduction in the number of sexual partners, and an increase in condom use. PEPFAR will implement innovative, new prevention interventions and improve ongoing interventions, including increasing access to quality PMTCT services and mobilizing moral and traditional authorities to lead on HIV prevention. FY 2010 activities include expansion of STI prevention, addressing alcohol abuse, expansion of couples counseling and testing efforts, integration of HIV prevention messages and counseling into other HIV and health services, better targeting of risk populations, development of linkages with community groups to ensure follow-up, and prevention with PLWHA, and VMMC services expansion.
PEPFAR support will provide OVC with improved access to educational opportunities, food and shelter, psychosocial support, health care, livelihood training, access to microfinance, and trained caregivers. Palliative care activities will reach HIV-infected individuals at clinical and community service delivery sites by providing nursing/medical care, treatment of OIs, pain relief, nutritional supplements, psycho-social support, referral to ART and ART adherence programs, and pediatric and family support. Tens of thousands of trained volunteer caregivers, as well as clinical service providers, will conduct these activities. To address the high proportion of TB/HIV co-infection, PEPFAR will continue to enhance the linkage between TB/HIV services. To support Zambia in building health worker capacity, PEPFAR in conjunction with GRZ will increase the number and improve the expertise of health and social workers. PEPFAR will support health worker training institutions to ensure inclusion of state of the art HIV prevention, care and treatment information in pre-service and in-service training curricula.
As of March 2009, Zambia’s 250 ART centers were receiving PEPFAR support. In FY 2010, PEPFAR will continue to provide comprehensive adult and pediatric ART services to public and private sector hospitals, clinic sites, and provincial and district public sector facilities, including training health care providers on provision of quality ART services; strengthening effective service delivery networks and linkages; strengthening laboratory, logistics, and HMIS; and promoting adherence to ART.
Funds will strengthen local HMIS, expand use of quality program data for policy development and program management, upgrade QA procedures, provide training and support, and build local partner capacity to launch and sustain programs. Activities in FY 2010 will further provide TA to develop sustainable M&E systems, information, and adopt modern communication technology.
PEPFAR will place particular emphasis in FY 2010 on strengthening its PMTCT program. In particular, funding will be used to improve clinic and laboratory infrastructure for PMTCT services; update, disseminate, and provide training on policies and guidelines based on international recommendations; and strengthen community approaches to increase PMTCT coverage. In addition, PEPFAR will evaluate the impact of PMTCT, including measuring the cost of PMTCT, pediatric care, and community approaches; PEPFAR will also conduct strategic planning for PMTCT in conjunction with the development of the National AIDS Strategic Framework and the National Health Strategic Plan. With this investment, coupled with efforts on the part of the Zambian Government, PEPFAR expects to reduce mother-to-child transmission to less than 5% in supported districts.
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