Citam Plus Zambia

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Community Initiative for Tuberculosis, HIV/AIDS and Malaria plus related diseases (CITAM+) is a local Zambian NGO that was registered in June 2005 to help disseminate information on TB/HIV and AIDS co-infection through community sensitisation by members of the organization, most of whom have had TB and are now cured and some of whom are living with HIV and AIDS and have suffered from TB at one time or another in their life.

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Zambia: AIDS Must End by 2030

Posted by [email protected] on September 1, 2016 at 3:30 PM Comments comments (0)

Press Statement

2nd September 2016

Zambia: AIDS Must End by 2030

As the nation awaits determination of the election by the Constitutional court on the petition filed against President- elect, there are issues related to citizen’s health that need to be decided upon. We can no longer afford to continue waiting for the petition when decisions around health are needed NOW!

According to the 2015 HIV estimates from the Joint United Nations Programme on HIV/AIDS (UNAIDS) on Zambia, the adult HIV prevalence stands at 12.9%. Out of this there are about 640,000 women aged 15 and over living with HIV, 85,000 children aged 0 to 14 living with HIV, around 20,000 deaths recorded due to AIDS and 380,000 orphans due to AIDS aged between 0 to 17 years old. There is still the need to step up efforts and programs to ensure that people living with HIV (PLHIV) who start treatment continue on treatment so as to avoid drug resistance and opportunistic infections such as TB as well as further spread of HIV. Although 70% of people that have been identified as TB patients are co-infected with HIV, not all that need to be screened for TB have been screened for TB making it critical for Zambia to improve diagnosis for both infections.

According to the Global Fund, 20 million people globally have been initiated on antiretroviral treatment as part of efforts that have saved an estimated 17 million lives since its founding in 2002. In Zambia there are between 1.2 million and 1.3 million Zambians living with HIV, 830,000 people are currently on ART, 91,000 new Tuberculosis smear positive cases have been detected and treated. Furthermore, for Malaria 15,600,000 insecticide treated mosquito nets have been distributed and all this is thanks to the Global Fund. To date there has been a Global Fund investment in Zambia of US$883,850,928. The Global Fund aims to raise US $13 billion to drive its work for the next 3 years, during which time they expect to save a further 8 million lives. The Global Fund is committed to “Ending AIDS by 2030” but this needs serious commitments from everyone especially world leaders. Over the years we have seen and experienced the Global Fund’s efforts in Ending AIDS by 2030, but the Global Fund Must be Fully Funded! Many recipient African countries such as Malawi, South Africa, Kenya and Nigeria did make their commitment known during the last Global Fund replenishment. On 16th September 2016, there will be a Pledging Conference that will be held in Montreal, Canada, where world leaders will play their part by making known their pledging commitment to the Global Fund. During the last Replenishment conference, Kenya committed itself by making a pledge of USD $2million and on 26th August 2016, the Kenyan President set the pace for other African leaders by making an announcement that Kenya has pledged USD $5million to the Global Fund’s fifth Replenishment, in a show of clear political will by the Kenyan President.

In a meeting that took place in at the Ministry of Health in December 2014 between Zambian CSOs working around TB, HIV and Malaria led by CITAMplus with Yvonne Chaka Chaka, a distinguished artist, humanitarian, Roll back Malaria and United Nations Children Fund (UNICEF) Good will Ambassador, and the Minister of Health and representatives of the ministry of health, there was an indication by the Minister that Zambia was going to make a pledge to the fifth Replenishment of the Global Fund in 2016. This was very exciting news to us as a constituency of people living with HIV/TB and to everyone affected by TB/HIV and Malaria. However, today the pledge has not been made public. The Pledging Conference will be held in Canada in September this year, we would like to call on the Zambia government to make their pledge and commitment known before the pledging conference.

As frontline activists, we call on the Zambian government to undertake the following:


1. Having been recipients of so much Global Fund support, we call on the Zambian government to make their pledge public. Now is the time because there are so many basic things that we still depend on Global Fund in order to support our people in the communities. However, the Global Fund also needs to be fully funded in order for it to support financial resource constrained countries such as Zambia.

2. It is our concern that as per ministerial speech presented in Parliament that construction of 650 health posts was not completed by April 2016; there has not been any update for these much needed services for our fellow Zambians and we call on the Ministry of Health to make known the current status of the health posts.

3. Much of the Zambian health budget depends on external support. As a country we need to take charge of our people’s health NOW by increasing domestic funding. We have an opportunity to increase domestic funding in that we are soon to have the Minister of Finance present the national budget to Parliament and the Zambian people.

If Zambia is to continue being held as a “ walking the talk nation” then not all is lost as Zambia can still make their commitment to the Global Fund during the upcoming pledging Conference as well as take more control of delivering health to its people by increasing domestic finding. Furthermore, we call on government to exercise political will so that work on the 650 health posts is completed this calendar year.

CITAMplus is an organization that focuses around policy advocacy and citizen led grassroots advocacy among other things. It is a partner of ACTION which is a partnership of locally-rooted organizations around the world that advocate for life-saving care for millions of people that are threatened by preventable diseases.



Issued by Nathan Nhlane

Policy and Advocacy Officer/Grassroots Manager

Phone: +260 968 277 388 /+260 979 220 230/ +260 950 597551

E-mail: [email protected]

Tweeter: @CitamPlusZambia




An inspirational article to read

Posted by [email protected] on August 29, 2016 at 9:50 AM Comments comments (0)
An inspirational article to read.

"An interview with Zambian global health advocate".

TB/HIV Advocate And CITAM+ Executive Director Honored By Dalai Lama (2014)

Posted by [email protected] on August 28, 2016 at 4:30 PM Comments comments (0)


TB/HIV Advocate And CITAM + Executive Director Carol Nawina Maimbolwa Honored By Dalai Lama

Posted by ACTION Secretariat, Washington, D.C. on Feb 21, 2014 |

This weekend, ACTION partner and friend Carol Nawina Nyrienda will be honored by His Holiness the Dalai Lama as an "Unsung Hero of Compassion" -- an award recognizing leaders around the globe who work to alleviate the suffering of others without expectation of reward. Carol is the Executive Director of CITAM+ in Zambia, a patient-led organization providing Zambians with life-saving information and care. The profile below is reposted from Unsung Heroes of Compassion.


Carol Nawina Nyirenda is tireless—one day advocating at the World Health Organization, another speaking at an international AIDS conference, yet another building a rural health clinic in her native Zambia. What gives this passionate, articulate activist her energy is that, unlike many of her friends and family, she has survived HIV.


“There must be a reason why I’m still alive,” she says. “I went to rock bottom, but I survived. I want to inspire people by showing them that you can be HIV-positive and still lead a normal, productive life.”


Born in rural Zambia in 1963, Carol was leading a middle-class life with her husband and two children when people around her began dying of a disease not seen before. Soon her world began to collapse. Her husband got sick. They lost their home and then separated. Carol and her daughter moved in with relatives, apart from her husband and son. Months later, she got a phone call telling her that her husband had died; HIV was never mentioned.


In 2001, Carol became ill. She was diag- nosed with Kaposi’s sarcoma, a cancer common in people with HIV. When she began coughing, her brother, a doctor, suspected she had tuberculosis(TB). He urged her to be tested for TBandalso for HIV. “I was highly offended,” she remembers. “I had been a faithful wife and thought I was safe.”


In 2002, Carol received the diagnosis that changed her life. “I felt very angry,” she says. “My husband was gone. I had HIV, cancer, and TB. Why had God done this to us?” The AIDS epidemic hit Zambia hard in the 1980s, but even 20 years later when Carol was diagnosed, HIV was seen as a death sentence: it wasn’t a question of if you would die, only a question of when.


Carol sought treatment in a neighboring town to keep her condition secret, but news of her illness soon leaked out. People stopped coming to her restaurant. She ran out of money for expensive antiretroviral drugs. The hospital providing her chemotherapy told her brother to save his money for her funeral rather than spending it on more treatment. Feeling hopeless, she went home to her mother to die.


Then, in 2003, through George W. Bush’s President’s Emergency Plan for AIDS Relief, the U.S. sent antiretroviral medications to Zambia and Carol was able to access free treatment. “I wanted to survive for my children,” she says. “I dreamt that one day I could start an organization to help others like me.”


Her mother encouraged Carol to join an HIV support group, but Carol hesitated. Then, she says, “I heard about the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and helped write a proposal to fund our patient group.”


Carol has since become an internationally known TB and HIV activist, launching numerous projects to help people recover from what she calls “the Thriller Syndrome.” She explains: “In the Michael Jackson video, people come out of the grave walking around like zombies. That’s what it feels like—when people are diagnosed with HIV, they are alive but not really living. I want to help them wake up and bring them back to full lives.”


In 2008, she founded the Community Initiative for Tuberculosis, HIV/AIDS, and Malaria, a patient-led organization providing Zambians with life-saving information and care. She chairs the Coalition of Zambian Women with HIV. She is president of the Africa Coalition on TB. Her latest endeavor, the Nambwa Project, is creating access to health care, education, and self-sustaining income for a rural community in Zambia heavily affected by HIV. “I bridge the gap,” Carol says. “People are willing, sometimes they just need a little help.”


Carol is indefatigable in her activism, and optimistic about the future. “I refuse to be beaten,” she says. “Life gave me a lemon, but I wanted a banana. So I made lemonade, sold it, and bought the banana I wanted.”

Prisoners in Zambia Need Better Access to HIV Services

Posted by [email protected] on August 26, 2016 at 5:55 AM Comments comments (0)

By Patrick Maboshe

As the Zambia Prison service embarks on a campaign to reduce HIV prevalence among men who have sex with men, gay rights activists say more needs to be done to tackle homophobia and discrimination in the country.


Prisoners are one of the groups who are most vulnerable to HIV infection. Percy Chato, commissioner of Zambian Prisons, said prison service data as of November 22 last year, showed that the HIV prevalence rate among 3,008 male prisoners stood at 10 percent while it was five percent among 104 female inmates.


Chato said HIV infection in Zambian prisons is due to ongoing transmission related to overcrowding and a lack of adequate prevention and treatment services.


"The challenge we are faced with as prisons administrators is that we do not know to what extent it [homosexuality] exists or whether it is a forced sexual practice or consensual sexual practice," he added. "Therefore, the issue of men having sex with men in prisons requires further investigations."


According to Chato the prison service, with the help of various stakeholders, is carrying out an HIV/AIDS sensitisation programme to promote abstinence from sex. He claimed the programme will help lower HIV infection rates among prisoners.

Human rights crisis


HIV prevention among men who have sex with men and LGBT people in Zambia is a contentious issue. Same-sex sexual activity between both men and women has been criminalised since British colonial rule and a sodomy conviction carries a 14-year prison sentence.


Although certain clauses in the country's constitution may be interpreted as overriding this, they do not specifically ban discrimination against LGBT people.


Frank Chanda, a human rights, LGBTI and HIV/AIDS advocate, said that Zambia needs: "LGBT-centered dialogue that tackles the social and political issues that currently drive homophobia across the country."


Churches oppose condoms in prisons


As well barriers within the legal system, Zambia's LGBT community face opposition from the country's churches, which are against promoting gay rights. They oppose the distribution of condoms in prisons on the grounds that this promotes homosexuality. Supported by the churches, the prison service promotes abstinence as its main prevention approach.

Zambia Episcopal Conference spokesperson Fr Paul Samasumo said the Catholic Church does not support gay rights. He said the church is working with prison staff to make prisoners aware of how to protect themselves from HIV infection through abstinence, and how to access antiretroviral treatment.


Chato said that Zambian prisons had seen a decrease in HIV prevalence during the campaign. "Most inmates are now more aware of the danger of indulging in sodomy and its consequences," he said.


One inmate of Mongu Central Prison, who asked not to be named, said that prisoners supported this approach. "We would rather embrace programmes for good behavioural change than consent to the distribution of condoms," he said.


LGBT activists continue to argue that more needs to be done to help men who have sex with men in the wider community to protect themselves against HIV. As a result, they face arrest and prosecution.

Gay rights activist Paul Kasonkomona was recently arrested after defending same-sex relations on Zambian television. The government charged him with "inciting the public to take part in indecent activities". If convicted, Kasonkomona would have been imprisoned for one month or fined.


He said he was arrested for speaking out about the need to protect gay rights in order for the HIV/AIDS epidemic in the country to be addressed; currently there are a lack of health programmes that cater for LGBT people.


"In particular, there is an urgent need to include men who have same-sex relationships in the country's National Aids Strategic Framework. In order to help this shift, there has been a move to collect baseline data on HIV/AIDS prevalence amongst men who have sex with men and women who have sex with women," he said.


"The Zambian government should take immediate action against government officials who make discriminatory statements against LGBT people, or arrest or detain them," Kasonkomona said. "The attacks on LGBT people need to stop."



Africa Region Ministers of Health Approve New Regional Framework for Ending TB, Endorse Global Plan to End TB 2016-2020 and 90-(90)-90 targets

Posted by [email protected] on August 26, 2016 at 5:40 AM Comments comments (0)

Africa Region Ministers of Health Approve New Regional Framework for Ending TB and Endorse the Global Plan to End TB 2016-2020 and 90-(90)-90 targets




22 August 2016, Addis Abiba - Ministers of Health from Africa met in Addis Ababa for a special session on Tuberculosis this weekend, as part of the Regional Committee of the World Health Organization AFRO Region. Co-organized by WHO and the Stop TB Partnership, the meeting focused on unifying Ministers of Health to end TB in the Region by 2030 and ended with a call to organize a United Nations High-Level Meeting on TB.


Earlier in the day, Ministers endorsed the new ‘Framework for Implementing the End TB Strategy in the African Region (2016 - 2010)’, which will support the adaptation and implementation of the WHO End TB Strategy. They also endorsed a Statement titled 'Leave No One Behind: Uniting to End TB in the African Region', which included an endorsement of Stop TB Partnership's Global Plan to End TB, the 90-(90)-90 targets, and called for updated National TB Policies and an increase in domestic financial resources for TB efforts.


Headlining the event was Dr. Aaron Motsoaledi, Chair of the Stop TB Partnership Board and Minister of Health, South Africa, who led the call for a UN High-Level Meeting on TB and presented on the larger-than-realized burden of TB in Africa and the impact it has on health systems and economies.


"There’s no doubting that TB remains the neglected child of all the major infectious diseases, and continues to remain in the shadows on the global stage", said Minister Motsoaledi. "It’s time for us to demand that TB receives the spotlight it deserves. A United Nations High-Level Meeting devoted to TB in September 2017 would be an important way to achieve this, to reframe TB from simply a technical health problem, to a global development challenge requiring a whole of society response."


Despite the high burden of TB on Africa’s health systems, governments contribute less than 19% on average to their annual TB strategic plans. Minister Motsoaledi called on his fellow Ministers of Health to advocate for greater TB funding in their countries, and engage with their Parliaments, People Affected by TB, and Ministries of Finance, citing the fact that TB has been established as one of the most cost effective investments in the Sustainable Development Goals (SDGs). Dr. Lucica Ditiu, Executive Director of the Stop TB Partnership, described how a global coalition of governments, development partners, communities and other stakeholders must be brought together in the fight to end TB.


Speaking on the threat of drug-resistant TB, Dr. Matshidiso Moeti, Regional Director for WHO Africa said, "The gains made in TB control could be wiped out by the threats of microbial resistance to medicines in future. The Ebola outbreak in West Africa and the negative effects it had on health systems is a good basis for reflecting on the consequences of a possible outbreak of untreatable TB in the future. This must avoided by all means."


The discussion included interventions by Health Ministers from Uganda, Zimbabwe, Nigeria, Lesotho and other countries. There was consensus that a working meeting needs to be held with the counterparts in Ministers of Finance on the importance of funding national TB programs. Investing in TB programs can yield $43 for each dollar invested - more than any other comparable public health program.


"As survivors we are committed to lending our voices and stories in honor of those who were not as fortunate and died needlessly", said Mr. Endalkachew Fekadu, Managing Director of Volunteer Health Services and a Person Affected by TB. "We feel it is our responsibility to show the world the human face of TB so that we all remember our fight is not only against a disease but also for the people its affects."


"Parliamentarians have a key role in leading the fight to End TB in Africa. The newly launched African TB Caucus will be a key driver in efforts to increase domestic resources for TB and I encourage Ministers of Health to reach out to their fellow Parliamentarians to support their efforts to elevate TB on the political stage. The time is now for us to join together", said the Honourable Mr. Stephen Mule, Co-Chair, Africa TB Caucus and Member of Parliament in Kenya.

Simple Test Could Quickly Detect Tuberculosis In Developing Countries

Posted by [email protected] on August 24, 2016 at 8:50 AM Comments comments (0)


By Robert F. Service

PHILADELPHIA, PENNSYLVANIA—Tuberculosis (TB) is one of the biggest scourges there is among infectious diseases, killing nearly 2 million people a year, most in developing countries. It is also notoriously hard and slow to detect in places without top-flight health care systems. Yesterday, researchers reported at the American Chemical Society (ACS) meeting here that they’ve devised a simple new way to diagnose TB, and even distinguish living TB cells from dead ones, which could give doctors an easy way to see whether their anti-TB medications are working. The researchers are now putting their diagnostic through its paces with samples from patients in South Africa, which has one of the world’s highest incidences of TB, and they hope to launch a clinical trial of their test soon.


According to the World Health Organization, nearly 10 million people contract TB every year. That happens when someone infected with Mycobacterium tuberculosis coughs, or even speaks, and others nearby inhale tiny, bacteria-laden droplets. In wealthy countries, doctors take lung x-rays of patients suspected of having TB and test their sputum (mucus and spit) for DNA markers of the bacterium. But in developing countries, where there is limited access to these technologies, technicians often turn to a procedure known as the Ziehl–Neelsen (ZN) test.


Developed more than a century ago, the ZN test spritzes dye-laden liquids onto a sputum sample. After extensive processing, those dyes latch onto water-excluding “hydrophobic” compounds that are abundant in Mycobacteria membranes. But the test is slow to administer, not particularly sensitive, and gives many false positives, because many bacterial membranes contain hydrophobic compounds, says Carolyn Bertozzi, a chemist at Stanford University in Palo Alto, California.


Bertozzi and her colleagues wondered whether there wasn’t a better way to flag TB. Her team had spent more than a decade studying how different organisms, including pathogenic bacteria, attach a wide variety of sugar compounds to the proteins and fatty molecules called lipids that make up their cell membranes. In their early studies they found that unlike most other bacteria, and most other organisms, Mycobacterium tuberculosis and its close relatives use a type of sugar known as trehalose to carry out this construction. “We wondered whether we could use this to mark TB cells,” Bertozzi says.


The researchers designed a series of different trehalose sugars tagged with a fluorescent dye abbreviated DMN. The dye glows bright green when it absorbs light—but not always. If it’s surrounded by even the slightest bit of water it doesn’t shine. When water is excluded, as it is in the hydrophobic interior of a cell membrane, the dye lights up. Bertozzi’s hope was that if her team fed their dye-labeled sugars to the TB bugs, the microbes would take them up and append them to their cell membrane lipids, turning them green. That wouldn’t happen for dead TB cells that can’t take up the sugar, nor for the cells of most other organisms, making it possible to spot a live TB infection in highly diverse sputum samples.


tuberculosis cells

In lab studies the researchers found just that. Bertozzi reported at the meeting that live Mycobacterium samples shone bright green under a fluorescence microscope, whereas those containing common bacteria, such as Escherichia coli or Staphylococcus aureus, didn’t fluoresce at all. What’s more, the live TB cells begin to glow in as little as 5 minutes after being fed the sugar, and turn bright green within 1 hour. ZN tests, by contrast, can take hours and often miss low levels of infection. Another standard test, wherein TB proteins are injected under the skin and doctors look for an immune response that shows a person has been infected, can take 3 days to produce a result.


Bertozzi and her colleagues also collaborated with Bavesh Kana, a biochemist at the University of the Witwatersrand in Johannesburg, South Africa, who provided sputum samples of patients suspected of having TB. Lab tests on those samples not only quickly flagged live TB, but showed a close match with more exacting DNA studies. Bertozzi says that she and her colleagues are hoping to launch a clinical trial of their diagnostic to test its success under real-world conditions.


“It’s pretty spectacular,” says Dale Boger, a chemist at the Scripps Research Institute in San Diego, California, who attended Bertozzi’s session. Boger adds, however, that even if TB is detected rapidly its resistance to current medications continues to be a major problem. Bertozzi notes that if the new test proves successful, it could help fight such resistance by allowing doctors to determine what medications are and aren’t working to defeat one of the most vexing and dangerous infectious diseases.

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