Right to Care was registered as a non-profit organisation (NPO) in Zambia in 2016. Right to Care Zambia is a fully-localised NPO.
Through the United States Agency for International Development (USAID) Action to HIV Epidemic Control project funded by USAID in Zambia’s Luapula, Muchinga and Northern provinces, we have focused on reducing HIV transmission, morbidity and mortality . This is in support of the United Nations Programme on HIV and AIDS and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) 95-95-95 goal encompassing:
- HIV treatment coverage and
- providing comprehensive HIV prevention, care, and treatment maintenance services.
The project aims to:
- expand prevention services,
- expand quality treatment and
- reach epidemic control.
Priority populations include:
- paediatrics,
- adolescents and young people and
- pregnant and breastfeeding women.
A fully-localised not-for-profit organisation
Right to Care Zambia (RTCZ) is a fully registered Zambian not-for-profit organisation with strong professional leadership and a good working relationship with the Ministry of Health (MoH), medical and public health schools, and the research community. RTCZ opened its doors in 2016. Since then, RTCZ has become a local NGO, led by a predominantly Zambian team. The RTCZ research department has been successful in acquiring further projects supported by NIH, Bill and Melinda Gates Foundation, MSD for Mothers, USAID – Zambia, and Grand Challenges Canada. RTCZ is headquartered in Lusaka and has supported projects in Northern, Muchinga, Luapula, Eastern, and Southern Provinces.
Our Partners
The lead funding agency of the EQUIP grant is the United States Agency for International Development (USAID) through the US President’s Emergency Plan for AIDS Relief (PEPFAR). Our EQUIP partners are:
- the National Health Laboratory Service (NHLS),
- the Anova Health Institute (Anova) and
- the Health Economics and Epidemiology Research Office (HE²RO) of the Wits Health Consortium at Wits University.
Our research partners with whom we work on local research programmes include:
- NIH Research Support – Boston University
- Bill & Melinda Gates Foundation – Boston University
- ELMA Philanthropies
- MSD for Mothers
- Grand Challenges Canada and
- USAID-Zambia.
Action to HIV Epidemic Control
Zambia has made significant progress in moving towards HIV epidemic control in recent years. However, additional work is needed to increase treatment coverage and reach the most vulnerable populations, especially adolescent girls and young women, and mobile and hard to reach populations who are disproportionately affected. The USAID Action to HIV Epidemic Control Project, also known as USAID Action HIV, is designed to reduce HIV-related mortality, morbidity, and transmission and enhance comprehensive HIV prevention, care, and treatment maintenance services.
The USAID Action HIV project aims to provide comprehensive HIV prevention, care, and treatment maintenance services in Zambia’s Luapula, Muchinga, and Northern provinces.
USAID Action HIV aims to reduce HIV mortality, morbidity, and transmission by achieving the joint United Nations Programme on HIV and AIDS (UNAIDS) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) goal of 95/95/95 HIV treatment coverage, meaning 95 percent of people know their HIV status, 95 percent of people who are HIV positive are on treatment, and 95 percent of people on treatment are virally suppressed. The project strengthens systems and provides direct service delivery at provincial, district, facility, and community level, with high HIV burden districts prioritized to achieve maximum impact.
Life of Project: June 2021 – June 2026
Geographic Focus: Luapula, Muchinga, and Northern Provinces
Partner: Right to Care Zambia
Chief of Party: Ben Chirwa
Total USAID & PEPFAR Funding: $90,868,479
USAID contact: Godfrey Lingenda – glingenda@usaid.gov
Goals
- GOAL ONE: Ensure access to comprehensive HIV prevention interventions
- GOAL TWO: Initiate 95 percent of those who tested positive on antiretroviral therapy (ART), andensure that 95 percent of those on ART are virally suppressed
- GOAL THREE: Strengthen monitoring and evaluation capacity at the facility, district, andprovincial levels for improved program management; strengthen facility-level commodity management to mitigate the risk of stock outs; and, strengthen the public financial management systems of the Ministry of Health and Ministry of Finance to enable the efficient use of direct government-to-government funds from USAID.
2023 Key results
- Out of the 109,937 pregnant women who attended antenatal care services, 108,934 had aknown HIV status. The 1,003 women without a known HIV status were tested during subsequent visits to prevent mother to child transmission of HIV during pregnancy.
- Administered an early infant diagnosis test to 6,349 infants exposed to HIV within their first12 months of birth.
- Integrated voluntary family planning services into 614 health service delivery sites (out of atotal of 812 supported sites) making it easier for people to access family planning and HIV services at the same time.
- Provided 41,063 males aged 15-29 years with Voluntary Medical Male Circumcision throughoutreach activities to schools, markets, recreation centers, and bus stations.
- Provided 23,455 people with Pre-exposure Prophylaxis (PrEP).
Towards HIV epidemic control in Zambia
To control the HIV epidemic under the USAID Action to HIV Epidemic Control project, Right to Care Zambia focuses on:
01. Ensuring access to comprehensive HIV prevention interventions
02. Initiating 95% of those who test positive onto antiretroviral treatment (ART)
03. Ensuring that 95% of those on ART are virally suppressed
04. Reaching 95% of eligible HIV positive adults and children with nutrition, counselling and support and integrated voluntary family planning services
05. Providing cervical cancer screening services for women living with HIV at HIV service delivery locations
06. Providing tuberculosis preventive treatment,
07. Strengthening monitoring and evaluation capacity at facility, district and provincial level for improved programme management
08. Strengthening facility-level commodity management to mitigate the risk of stock outs and
09. Strengthening the public financial management systems of the Zambian Ministry of Health and Ministry of Finance to enable the efficient use of funds from the U.S. Government
To strengthen our work, Right to Care Zambia also focuses on building monitoring and evaluation (M&E) capacity at facility, district, hub and provincial levels.
Primary prevention methods
Towards UNAIDS’ 95-95-95 targets
The first 95
Included in our efforts, under the EQUIP grant to ensure that 95% of people know their HIV status, RTC focuses on:
- targeted case finding,
- index case testing, and
- the use of mobile technology such as the Lynx community app for testing and GeoSpatial mapping of high yield areas and communities.
The second 95
In Right to Care Zambia’s efforts to ensure that HIV positive people in Zambia receive sustained antiretroviral treatment (ART), we focus on:
- linking HIV patients to treatment and care,
- tracking and tracing patients who have treatment interruption (lost to follow up)
- Up-scaling differentiated drug delivery (DDD) through mechanisms such as:
- Multi-month scripting and dispensing (MMSD) for a six month period,
- Establishing community medicine pickup points, and
- Supporting the Centralised Dispensing Unit (CDU) in Ndola, Copperbelt, which provides centralised dispensing services to patients. The CDU programme can dispense some 1.2 million repeat scripts per year. Its focus is on decongesting health facilities in Zambia.
The third 95
To achieve viral load suppression in 95% of patients on ART, Right to Care Zambia have:
- increased viral load testing capacity in laboratories,
- expanded the use of eLABS,
- implemented an early warning/alert system for patients with high viral loads,
- introduced a viral load sample collection and courier system, and
- increased TB preventative treatment in patients with HIV.
