Zambia’s Fight Against HIV/AIDS Progress, Challenges, and the Path to Zero New Infections by 2030

On December 1st, Zambia commemorated World AIDS Day under the theme “Take the Right Path, My Health, My Right.” A few days later, the country hosted the 16th Annual National HIV/TB/STI/Viral Hepatitis Conference, focusing on sustaining the UNAIDS 95-95-95 targets while revitalizing HIV prevention. These events highlighted the importance of human rights in the fight against HIV/AIDS and celebrated Zambia's progress in addressing the epidemic.

Zambia has made significant strides toward meeting the ambitious UNAIDS 95-95-95 targets, which aim for 95% of people living with HIV to know their status, 95% of those diagnosed to be on antiretroviral therapy (ART), and 95% of those on ART to achieve viral suppression. As of September 2024, Zambia has surpassed these targets, with 98% of people living with HIV knowing their status, 98% on ART, and 97% achieving viral suppression. Over 1.3 million Zambians are now on ART, and AIDS-related deaths have decreased by more than 60% over the past decade.

Health Minister Elijah Muchima expressed optimism about these achievements, attributing them to increased HIV testing, better linkage to care, and improved responses in high-transmission areas. These successes are the result of the combined efforts of the government, health workers, civil society organizations, and international partners. Zambia’s ability to expand HIV testing and treatment serves as an example for the region as the country moves closer to its goal of zero new HIV infections by 2030.

However, Zambia still faces challenges, particularly regarding vulnerable populations. One key issue is identifying and treating children with HIV. Many children contract the virus through mother-to-child transmission during pregnancy, labor, delivery, or breastfeeding. There is a significant gap in diagnosing children aged 0-14, which remains a major barrier.

 Additionally, low HIV testing among adolescents, who represent a high number of new infections, exacerbates the situation. Vice President W.K. Mutale Nalumango expressed concern about the high rates of HIV infections among young people, noting that 38% of new infections occur among youth who often lack access to comprehensive health education and life skills.

The 2024 Zambia Demographic Health Survey showed that 43% of adolescents aged 15-19 have poor comprehensive knowledge of HIV, contributing to the risk of new infections. Addressing this knowledge gap is crucial for reducing transmission rates and empowering young people to make informed decisions about their health.

To achieve the goal of zero new HIV infections by 2030, several strategic actions must be prioritized, particularly for at-risk groups such as adolescents, men, and children. Key recommendations include:

1. Adolescent Support Groups and HIV Education: Establishing adolescent support groups in schools, workplaces, and communities can provide safe spaces for young people to learn about HIV prevention and treatment. HIV/AIDS clubs in schools should focus on educating students about safe sexual practices, including abstinence, condom use, pre-exposure prophylaxis (PrEP), post-exposure prophylaxis, and the importance of HIV testing and linkage to care.
2. Scaling Up HIV Self-Testing for Men: Men have been underrepresented in HIV testing and treatment programs, posing a significant barrier to the national response. Expanding HIV self-testing among men through clinics and community-based testing, including door-to-door services, is essential. Reducing stigma and reaching men, especially in rural areas, through health posts and community-based services will improve access to HIV services.
3. Maternal HIV Testing and Care: Improving maternal HIV testing and care is critical in reducing mother-to-child transmission. Pregnant women should be encouraged to test for HIV early and receive the necessary treatment and counseling. HIV-positive mothers should begin ART immediately, while HIV-negative women should be offered PrEP to prevent transmission during pregnancy. Monitoring and prophylaxis for exposed children should also be prioritized to ensure early identification and treatment.
4. Leveraging Digital Media for HIV Education: Digital media platforms such as Facebook, Instagram, TikTok, and local radio and TV stations can effectively reach younger, tech-savvy audiences. Using these platforms to disseminate HIV prevention and treatment messages can enhance community outreach, especially among youth, and encourage them to seek HIV services.
5. Community-Based HIV Testing and Education: Increasing access to HIV testing through community-based interventions is essential. Initiatives such as door-to-door testing, outreach programs in schools, markets, churches, and sports events, as well as partnerships with local businesses, can significantly raise testing rates and ensure that more people know their HIV status.
6. Enhancing Pediatric HIV Detection: There is a need for more effective strategies to identify children living with HIV. Expanding pediatric HIV care programs and ensuring that infants born to HIV-positive mothers are tested and treated early is crucial. Scaling up strategies to eliminate mother-to-child transmission will help ensure that no child is left behind.

While Zambia has made remarkable progress in addressing the HIV/AIDS epidemic, much work remains to be done. Achieving the goal of zero new HIV infections by 2030 requires sustained efforts and the collective involvement of all sectors of society, from government and health workers to civil society and communities.

Zambia must continue to expand HIV prevention and treatment programs, particularly for young people, men, and children. HIV education and testing must be prioritized, stigma must be addressed, and health services must be made more accessible to those in need. By implementing these strategies and learning from the successes and challenges highlighted during the World AIDS Day and HIV Conference events, Zambia can continue its progress toward a healthier future for all its citizens.