If you’re a regular follower of our blog, you may have already gathered from last week’s post about TB in Zambian prisons that RESULTS led a cross-party parliamentary delegation to Zambia at the end of August. The delegation looked at key global health issues, including TB, TB-HIV co-infection and research into an AIDS vaccine. In addition to Lusaka Central Prison, we were able to visit a number of health clinics, speak with health workers and meet with Government ministers and officials.

An end to AIDS? Addressing the AIDS epidemic through health interventions and research:

The trip kicked off with a visit to two government clinics in Lusaka offering free testing and counselling to discordant couples where one partner is HIV positive and the other is HIV negative. Counselling and testing is provided by ZEHRP (Zambia-Emory HIV Research Project), an NGO that receives funding from the International AIDS Vaccine Initiative (IAVI) and works in collaboration with the Zambian government to offer these services at 60 government clinics.

In addition, ZEHRP is leading on research to find an AIDS vaccine, something that is urgently needed if we are to achieve an end to the AIDS pandemic. Thirty-four million people are currently living with HIV worldwide and require lifelong treatment to lead healthy and productive lives. An HIV vaccine would save lives and could significantly reduce AIDS-related costs.

Supporting innovative techniques to find people with TB:

As part of our ongoing work advocating for more resources for TB REACH, we visited two TB REACH supported sites. TB REACH is a funding mechanism that awards grants up to US $1 million for a one year period to find people with TB quickly, avert deaths and stop TB from spreading. TB REACH has been the single largest supporter of GeneXpert (a new TB diagnostic tool) rollout to date.

We had the opportunity to see the GeneXpert machine in practice at the Kanyama Health Clinic in Lusaka, which treats over 10,000 TB patients every year. The NGO ZAMBART opened a tuberculosis diagnostic area at the clinic that includes a digital x-ray machine as well as the GeneXpert machine. GeneXpert is being used in this setting to diagnose TB in patients with HIV who are much more difficult to diagnose using a traditional microscope to examine a sputum sample.

The second TB REACH supported site we visited was Lusaka Central Prison, where TB REACH provided CIDRZ a grant to screen every prison inmate for TB and HIV. Prisoners are a neglected population at high risk for both TB and HIV infection. Effective TB control in prison protects prisoners, staff, visitors and the community at large as diseases do not respect prison walls.

The delegation was able to visit the prison facility and witness the poor living conditions conducive to the spread of disease, including prison cells so cramped at night that prisoners are unable to lie down to sleep. As part of the prison visit, delegates were able to hear about prisoner grievances from the prisoners themselves and were able to watch a skit put on by the prisoners’ drama group that included TB messaging and what to do when you experience TB symptoms.

The Global Fund to Fight AIDS, TB and Malaria:

The Global Fund is the most successful financing mechanism funding health in the world to date. The delegation was able to visit one Global Fund supported site at the rural Mpanshya Hospital run by the Churches Health Association Zambia (CHAZ). Delegates were able to see the fantastic work being carried out at this district level hospital as well as learning about some of the challenges health workers face.

One of the significant difficulties we learned about included being able to keep the hospital’s pharmacy cool enough to store medication. As the hospital is located in a very rural area, it is not on the national electricity grid, meaning it relies entirely on generators for electricity. In the summer time, when temperatures reach the 40s Celsius, the hospital struggles to keep the pharmacy to the required 25 degrees in order to store medicines.

The delegation was also able to hear from community health workers that included TB and HIV treatment supporters, traditional birth attendants and former TB patients. These workers carry out their work entirely voluntarily and often cover long distances by foot in order to be able to reach patients. Their commitment to improving the health of their communities was truly inspirational and left the delegates wanting to engage further in global health issues.