The Centre for Infectious Disease Research in Zambia (CIDRZ), together with the Association of Public Health Laboratories (APHL), Wits Health Consortium (WHC), Clinical and Laboratory Standards Institute (CLSI) and FIND Diagnostics have established a consortium to support ‘Transitioning and Integrating Laboratory Services for High Quality HIV Diagnosis, Care, Treatment, and Monitoring to the Ministry of Health (MOH) to sustain achievement of the 95-95-95 Goals in Zambia under PEPFAR’.
Effective and efficient disease diagnostics are an essential component of any resilient health system. Strong laboratory (lab) diagnostic capacity is important for disease surveillance, diagnosis, prevention, treatment, health promotion now more than ever, given the myriad of potential global health threats. Labs are a critical component in achieving the UNAIDS 95-95-95 targets to have an AIDS-free generation, respond to emerging pathogens and provide optimal care for HIV+ individuals. Over the past decade, tremendous efforts have been made to develop and strengthen lab systems to adequately respond to the scale up of the ART program in PEPFAR countries and adapt these to health challenges; however, several barriers persist in creating sustainable, accessible, and efficient high-quality systems that governments can administer with minimal external support.
Zambia continues to make progress towards ending the AIDS epidemic by 2030 by adopting the 95-95-95 targets. The country has attained the second (98%) and third (96.3%) target among persons >=15 years of age. Despite these remarkable accomplishments, challenges remain in attaining the first target among adults, for children <15 years and key and priority populations across all three targets. Addressing the remaining programmatic challenges in diagnosis, treatment, adherence, and full government implementation of the health system will accelerate Zambia’s attainment of the UNAIDS and PEPFAR goals.
Our Consortium has over 20 years of combined institutional experience in Zambia and the sub-region to expand HIV prevention, care and treatment services including lab systems strengthening. More specifically, we have mentored labs to achieve international ISO15189 accreditation, provided technical and material support to establish and improve integrated sample courier networks, digital sample referral and results return, waste management, backup power systems and assisted government to find gaps and fix them at all levels of lab operations.
Our consortium will implement proven strategies that include the development and sharing of policies and guidance, and implementation of activities that: 1) maintain continuity with prior lab strengthening efforts in digital sample referral and results return, integrated sample courier systems, quality management systems, medical waste management, power backup and other gaps in the lab value chain; 2)provide technical assistance (TA) to achieve full system functionality at all levels of the lab network from facility to national level; 3) conduct capacity assessment of partner-supported lab systems including costing required to maintain lab services, and 4) transition lab services to full government control through a stepwise transition approach for MOH implementation and oversight.
Our approach is anchored in proven experience building and strengthening public -private partnerships, promoting country ownership/ leadership, and providing knowledge and material support to government technical working groups to develop policies for increased access to high quality lab testing. Our consortium has also been able to empower government staff to support the integration of lab services and systems, training, and logistics.
Our Consortium will work collaboratively with the Zambian Government through the MOH and other stakeholders to achieve our vision of a resilient and sustainable high-quality National Laboratory Network fully managed by the Zambian government.
