Zambia
In Zambia, tuberculosis continues to be a major health threat. The TB case notification rate is 150 per 100,000 people, twice the African regional average. After achieving increases in case detection in the previous two years, the rate decreased from 62 percent in 2003 to 54 percent in 2004. The treatment success rate also fell from 83 to 75 percent, lower than the global target of 85 percent. Over half (54 percent) of all TB patients in Zambia are co-infected with HIV.
In 2002, Directly Observed Therapy, Short-Course (DOTS) was reinvigorated and expanded, receiving renewed government commitment and an assured supply of anti-TB drugs through the Global TB Drug Facility. By 2003, Zambia implemented the DOTS strategy nationwide, achieving 100 percent DOTS coverage. Unfortunately, an estimated HIV prevalence of 17 percent in the adult population is fueling the TB epidemic and straining already limited financial and human resources. In response, Zambia’s National HIV/AIDS/STI/TB Strategic Plan has identified the treatment of TB as a specific objective for the reduction of the socioeconomic impact of HIV/AIDS in the country.
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Note: All data are for 2004 except where noted otherwise.
Source: Global Tuberculosis Control: WHO Report 2006 |
USAID Approach and Key Activities
USAID’s TB program in Zambia began in FY 2005 with a budget of $1 million, which supported the initial assessment of the Zambia National Tuberculosis Control Program (NTP). The findings of this assessment were used to inform the National Tuberculosis Strategic Plan. USAID, through the Tuberculosis Control Assistance Program (TBCAP Project), currently supports NTP activities in Copperbelt, North-Western, and Luapula provinces. The program will expand to an additional two provinces in its second phase, thus covering five of Zambia’s nine provinces. Through efforts to strengthen capacity at all levels of the health system, the TBCAP Project aims to ensure that these provinces will meet the global targets for case detection and treatment success.
Through implementing partners, USAID supports the NTP in the areas of:
- Strengthening and expanding quality DOTS services
- Improving collaboration between TB and HIV/AIDS programs at the provincial and district levels
- Improving laboratory systems, with activities such as supply and specimen management
- Increasing community involvement and awareness of TB
- Expanding public-private partnerships, including the development of TB and TB-HIV/AIDS activities in the workplace
USAID Program Achievements
Though the TBCAP Project is only in its second year, USAID’s assistance has contributed to improvement in human resources and infrastructure through the following activities:
- Provided laboratory personnel to help build human resource capacity
- Procured laboratory supplies
- Printed and circulated manuals
- Conducted training of staff and health workers in laboratory technology and HIV/AIDS counseling and testing for TB patients
- Facilitated supervisory field visits to implementing sites
- Supported national and provincial meetings for promoting public-private partnerships
Case Detection and Treatment Success Rates Under DOTS
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Note: DOTS treatment success rate for 2004 will be reported in the 2007 Global Report.
Source: Global Tuberculosis Control: WHO Report 2006. |
Partnerships
USAID support to the NTP is provided through the Tuberculosis Control Assistance Project (TB CAP Project). The TB CAP Project local partners include Family Health International, WHO, and Management Sciences for Health. Other key international organizations that support the NTP include the KNCV Tuberculosis Foundation, the Japanese Anti-Tuberculosis Association, and the U.S. Centers for Disease Control and Prevention. Zambia received $47.3 million from the Global Fund for AIDS, Tuberculosis and Malaria in 2003.
September 2006
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