Author: Esther Muyangana of GHSC-PSM, Zambia

According to recent global estimates by the Joint United Nations Programme on HIV/AIDS (UNAIDS), AIDS is still the leading cause of death for women of reproductive age. Pregnant women living with HIV are at a greater risk of experiencing pregnancy complications compared to women who are HIV-negative and at increased risk of life-threatening infections, such as sepsis, and opportunistic infections including tuberculosis (TB), pneumonia, and meningitis.

USAID, through investments from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), is partnering with the Zambian government and other key stakeholders to provide care and support for women living with HIV during pregnancy, delivery, and postpartum - women like Purity.

Purity was diagnosed with HIV four years ago during an antenatal visit. “It was not easy to accept this news as I was preparing for the birth of my child,” she said.

Fortunately, Purity received great support from her family, and she speaks highly of the care and counseling she received from her local health care workers. The physicians and pharmacy staff at the USAID-supported Chitanda Health Center helped her understand and accept her status, and immediately started her on life-saving HIV treatment. 

For women who are pregnant and living with HIV, connecting them to treatment early on in their pregnancy is critical to prevent mother-to-child transmission of HIV.

After receiving support from the clinic and the USAID Global Health Supply Chain Program (GHSC-PSM), Purity is now happily taking care of her daughter who was born HIV-negative.

As part of her treatment plan, Purity is taking the HIV medication tenofovir/lamivudine/dolutegravir (TLD). This is the antiretroviral (ARV) treatment recommended by the World Health Organization (WHO) and procured by USAID through PEPFAR funding. TLD is considered the gold standard in HIV treatment because it has fewer side effects than other HIV treatments and is proven to rapidly suppress viral load in adult and adolescent patients with HIV. In August 2018, the Zambian government began a countrywide rollout of TLD for adults and adolescents. USAID and its partners have led a global transition to TLD with 15 PEPFAR-supported countries reporting that at least 80 percent of the ARVs issued in 2022 were TLD.

Purity is now on a multi-month dispensing plan, a patient-centered strategy that allows her to receive six months of her ARV treatment at a time so that she does not have to visit her local health clinic every month to refill her prescription – this also means reduced transportation costs, less time away from her job, and more time to spend with her daughter. This patient-centered strategy of multi-month dispensing also lessens the burden on the rural clinic and pharmacy staff, who are often overwhelmed with patient visits.

The USAID Global Health Supply Chain Program-Procurement and Supply project ensures an uninterrupted supply of life-saving antiretrovirals and other medicine at the Central Zambia Medicines and Medical Supplies Agency (ZAMMSA). This means medicines are available at clinics and pharmacies throughout the country to support people living with HIV, like Purity. To date, the GHSC-PSM has delivered more than 79 million bottles of TLD globally and 12.1 million bottles of TLD in Zambia. This has contributed to saving more than 1.2 million lives through increased access to HIV treatment and laboratory services.

Now, because she continues to regularly take her HIV medication, Purity is virally suppressed. This means that Purity can live a longer, healthier life and the virus can no longer be transmitted.

When asked about her future, Purity says, “My vision of the future is just the same as when I [did not have HIV]. The treatment works very well and gives me a lot of hope.”

GHSC-PSM works closely with the Ministry of Health, ZAMMSA, Zambian supply chain companies (CHAZ, CIDRZ, EQUIP, eSCMIS, FHI360, GLOBAL FUND, PAMO, SAFE, UNFPA, USAID DISCOVER H), and local hospitals and pharmacists to closely monitor the supply chain, as well as to check that data is properly collected and analyzed to ensure supplies of HIV treatment are available in the communities for people living with HIV.

Through USAID and PEPFAR, GHSC-PSM ensures equitable access to quality medicines and services. GHSC-PSM provides procurement and distribution services and technical assistance to strengthen supply chains and promote global collaboration for the U.S. government program for HIV/AIDS.

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A pharmacist picks up a medication
Pharmacists at health clinics throughout Zambia dispense life-saving HIV treatment and critical advice for people living with HIV, helping them to understand their treatment regimen.
GHSC-PSM
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The Zambian Ministry of Health's smart card program improved access to health information, helping physicians and people living with HIV track medical history and progress.
The Zambian Ministry of Health's smart card program improved access to health information, helping physicians and people living with HIV track medical history and progress.
GHSC-PSM
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Members of the warehouse team performing an inventory check in the USAID GHSC-PSM project warehouse.
Members of the warehouse team performing an inventory check in the USAID GHSC-PSM project warehouse.
GHSC-PSM