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Zambia

Twenty years after the first case of AIDS was diagnosed in Zambia, the country continues to be hard hit by HIV, experiencing the economic and social impact of a mature, generalised HIV epidemic. The epidemic is fuelled by many factors, including migration, urbanisation, poor control of sexually transmitted infections, a weak economy and profound poverty. There is currently an estimated 1.1 million people living with HIV, of whom 1 million are adults.

While the national adult prevalence rate remains high at 17%, some people are more vulnerable to HIV than others. Young women between the ages of 15 and 24 are around four times more likely to be infected than young men of the same age. There are differences between rural and urban communities too – more than twice as many people in urban areas (23%) are infected than in rural areas (11%).

An estimated 25% of pregnant women are living with HIV, and due to inadequate provision of services to help prevent mother to child transmission, 40% of babies born to these women are also infected. Of the children living with HIV about 30,000 need ARV treatment, but by June 2006 only 3,000 children were accessing this support. In addition, Zambia has nearly one million orphan children, one of the highest HIV orphan populations in the world.

While prevalence rates are high, they do appear to have stabilised – however poor access to anti-retroviral treatment means that the death rate due to HIV continues to rise. In 2005, there were an estimated 98,000 deaths resulting from AIDS, and by 2050 an estimated total of 6.2 million people will have died from AIDS.

What we do

The Alliance began working in Zambia in 1999 as a partner in the Zambia Integrated Health Programme (ZIHP). This was a four-year multi-partner project developed by the United States Agency for International Development (USAID) in partnership with the Government of Zambia to support the decentralisation of health services. The Alliance’s contribution to the partnership centred on integrating HIV activities into community-level health services. To make a greater contribution to scaling up and strengthening community responses to HIV in Zambia, the Alliance established a country office in Lusaka in 2001. It was one of the first countries where the Alliance used a more direct model of implementation, establishing a branch country office rather than identifying a linking organisation given the need for urgent action in response to the epidemic.

The Alliance Zambia promotes an expanded, co-ordinated and comprehensive response to HIV through support to key national networks and multiple non-governmental and community-based organisation support mechanisms at both national and district level. It achieves this by significantly increasing the involvement and capacities of community-based organisations and associations of people living with HIV. The Alliance and its partners also contribute community experience and learning, and to planning and policy forums at national and district levels.

Alliance Zambia supports both the government and civil society to address HIV issues through the implementation of a number of different programmes and activities. These focus on the promotion of voluntary counselling and testing, improving access to HIV treatment and care, palliative care and the prevention of mother-to-child transmission. Prevention activities are implemented by seeking behaviour change, addressing stigma and discrimination and raising awareness of HIV through activities such as information education and communication.

Since it was established in 200, Alliance Zambia has grown and by the beginning of 2007 had a committed and effective staff of 26. In line with the Alliance’s long term vision to “Build up an alliance of national linking organisations working effectively together”, Alliance Zambia is now ready to make the transition from a country office to a locally registered, fully independent Zambian NGO. In addition to strengthening Alliance Zambia’s ability to support community action on HIV within Zambia itself, it will also be well placed to provide support to new partners in the region as the global Alliance looks to expand in Southern Africa, recognising that this region includes countries with some of the highest HIV infection rates in the world.

Current programmes

The Antiretroviral Treatment Community Education and Referral (ACER)

The Regional Stigma Training of Trainers Project

Health Communication Partnership (HCP)

Sub-granting to community-based partners

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