1. CITAM+ Engaging HIV Civil Society in TB ACSM Meeting, Cancun 30 Nov 2009 Carol Nawina Nyirenda National Coordinator Community Initiative for TB, HIV/AIDS & Malaria

2. Zambia Country Background Total Pop: 12, 160, 516m Administrative set up 9 Provinces 3 cities 72 districts Health Setup # of Hospitals 97 # of Health Centres 1,210

3. Epidemiological update 2009 HIV prevalence 13.1% Pregnant women HIV prevalence 19.3% People living with HIV 1,482,228 Paediatric HIV population 82,825 Adult HIV deaths 97,494 Paediatric HIV deaths 8,283 Number of Orphans due to AIDS 1,291,079 Statistics from UNAIDS Zambia Country Report of 2008

4. Background To CITAM+ Community Initiative for Tuberculosis, HIV/AIDS & Malaria (CITAM+) is a CBO with a network of TB/HIV support groups in the capital city and some parts of Zambia Established in 2005 by PLHIV / TB Constituents: 3 provinces, Members: 384 members of TB/HIV co- infected people

5. CITAM+ Lusaka Mongu Siavonga 81 support groups 2 support groups 1 support group CITAM+ and its members

6. Community level Through a project funded by OSI to support monitoring of and advocacy for collaborative TB/HIV activities – started TB/HIV advocacy TB being one of the main killers of PLHIV Started working with already existing HIV support groups by integrating TB – large HIV disease burden and most have had TB Addition of TB info on HIV information desks and set up new TB/HIV info desks Set up new TB/HIV support groups

7. CITAM+: National, Regional & International Engagement Member of the TB/HIV Joint Collaborative Body Member of the National Infection Control Guidelines Committee Member of the Zambia Civil Society Health Forum Member of the 3 I’s Network Member of the Partners Zambia E-Forum International level: Global Fund board/ communities delegation UNITAID, STBP, TB/HIV Activists (supported by TAG) ITPC, SATAMo, PATAM

8. Policy analysis – TB/HIV docs Support Group Formation Training in TB/HIV Treatment Adherence Training in DOTS Lay Psychosocial Counselling Community Outreach Information dissemination at health centres through information desks Food Distribution to co-infected patients CITAM+ Activities

9. Opportunities Have support of the DHMT to work in the clinics in information dissemination and food distribution to co- infected patients Have been nationally recognized as lead TB organization on the 3 I’s Project Most staff are HIV positive, have had TB and came from activist organizations and are treatment literate Staff have technical skills to do their work in training, community outreach and policy analysis. Strong support from NZP+, COZWHA and ZAMBART

10. OPPORTUNITIES Work through the geographical structures of NZP+ and COZWHA Enhanced capacity as a result of international exposure The GIPA Principle

11. Challenges Inadequate funding to implement activities and pay salaries. Lack of transportation to reach other areas hence have to rely on public transportation Government does not want to work with activists in terms of policy development.

12. 3 I’s NETWORK Formed after workshop organised by CREATE in conjunction with ZAMBART and CITAM+ Participants – HIV and TB NGOs, CBO’S, FBO’s, support group leaders, health care workers 3I’s and integrating of TB into already existing HIV advocacy strategies Partnerships CS Health Forum TWG within MoH

13. Members of 3I’s Network Capuchin HIV/AIDS Services (CHAS) CITAM+ International HIV/AIDS Alliance Network of Zambian People Living with HIV ZNARVS Railways Clinic Kalingalinga Clinic Treatment Advocacy and Literacy Ukani Support Group CIDRZ TB Alliance SUPPORTED BY: ZAMBART CREATE

14. Conclusion HIV NGO’s are now ready and willing to deal with the two diseases at the same time The government is also integrating activities at their level There is a gap between the two and these need to come together in order to have visible results at both community and national levels

15. Pictorial Highlights of some of the CITAM+ activities

16. Outreach Activities World TB Day 2009 CITAM+ uses drama for community outreach

17. Advocacy Activities CITAM+ members during demonstrations CITAM+ members advocacting for better health services during World AIDS Day

18. Capacity Building Training Lay Psychosocial Counselors Training Treatment adherence supporters in Siavonga

19. Supporting Support Group IGAs and Food Distribution Positive Living Garden for Lusaka West Support Group Food Supplements that are distributed to PLHIV