Zambia’s national HIV response is at risk due to a pause in US foreign aid, affecting vital services, particularly for youth and marginalized communities. Over 32 service centers have closed, impacting thousands. The government, alongside international partners, is strategizing to mitigate these challenges and sustain essential HIV services for continuity.
Zambia receives an estimated $600 million annually from the United States Government, with $367 million earmarked for the national HIV response in 2025 through the Presidential Emergency Plan for AIDS Relief (PEPFAR). However, a pause in US foreign assistance has severely disrupted HIV services, notably impacting prevention initiatives for adolescent girls and marginalized communities.
The closure of 32 drop-in centers has jeopardized HIV services for over 20,000 individuals in 7 provinces. In addition, DREAMS centers aimed at adolescent girls have been shut down across 21 districts, alongside 16 standalone sites offering voluntary medical male circumcision. Nearly half (49%) of PrEP services in Zambia are reliant on USG support.
The support system for HIV service delivery is in jeopardy, particularly as USG aids over 23,000 personnel, including vital health workers and community-based volunteers. Given that the Zambian Government may struggle to immediately integrate these workers, alternative strategies for health service delivery are being explored, including task shifting.
Despite challenges, USG partners are tentatively resuming services, although six districts in the Northern Province remain without any HIV services. Current supplies of antiretrovirals (ARVs) can last for the next year, although there are limited reserves for rapid testing kits and other essential diagnostic tools.
The Ministry of Health is dedicated to maintaining essential HIV, TB, and malaria services across public facilities. A high-level steering committee is being established, supported by the UN Joint Team on HIV and AIDS, to assess service gaps and develop a responsive strategy to counteract the effects of the paused assistance. A costed-impact mitigation plan based on necessary HIV service continuity has been presented to Government and partners.
The Joint Team is collaborating with the Ministry of Health and the National AIDS/TB/STI Council to identify and implement sustainable solutions, in alignment with the HIV Response Sustainability Roadmap 2025–2030 launched in December 2024.
In summary, Zambia’s HIV response is facing critical challenges due to halted US support, leading to operational disruptions across numerous health services. The Ministry of Health is actively working with partners to devise strategies aimed at recovering lost momentum and sustaining the essential provision of HIV-related services, with a focus on resilience and long-term solutions.
Original Source: www.unaids.org
