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AIDS Programmes
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National Strategic Framework: 2005-2009; see also 1999–2001
In January 2005, the Democratic Republic of the Congo finalized its National Strategic Plan for Scaling Up Access to Antiretroviral Therapy for the Period 2005–2009. The Plan includes strategies for training additional health workers to deliver antiretroviral therapy, expanding prevention and care facilities, strengthening the capacity of national laboratories and improving the procurement and supply management systems for antiretroviral drugs and other supplies.
Epidemiological Assessment:
Epidemic level and trend and gender data
The Democratic Republic of the Congo is facing a large-scale growing HIV/AIDS epidemic, with an estimated national average adult prevalence of 4% and 1.19 million people living with HIV/AIDS at the end of 2005. The principal mode of transmission is heterosexual. The most severely affected age groups are 20–29 years among women and 30–39 years among men. The epidemic has severely affected children – an estimated 770,000 children younger than 17 years had lost one or both parents to AIDS at the end of 2003. Data available from isolated surveillance activities conducted in the eastern part of the country suggest that the prevalence of HIV infection is higher there than in the west. The epidemic has been worsened by large-scale population movements resulting from the armed conflict and political instability of the mid-1990s, the related economic crisis, high levels of untreated sexually transmitted infections and weak health system infrastructure.
Major vulnerable and affected groups
Infection rates are high among sex workers, men working for the armed forces, mining workers, long-distance truck drivers, blood donors and prisoners. According to a survey conducted by Me´decins Sans Frontie`res in 2001, the prevalence of HIV infection among sex workers was 27%.
Policy on HIV testing and treatment
In 2002, the National AIDS Control Programme developed national guidelines for antiretroviral therapy and the treatment of opportunistic infections in adults in collaboration with the German Gesellschaft fur Technische Zusammenarbeit (GTZ). The guidelines are being revised to take into account issues such as treatment in resource-constrained settings, treatment for children, treatment for pregnant women and HIV and TB co-infection. HIV diagnosis is based on an algorithm combining two rapid tests with clinical signs. A CD4 count is mandatory before initiating antiretroviral therapy. The national guidelines promote HIV testing on a voluntary and confidential basis. The National Strategic Plan for HIV/AIDS for 1999– 2008 specifies that all reproductive health services should integrate services for preventing the mother-to-child transmission of HIV, including access to voluntary counselling and testing, antiretroviral therapy for women living with HIV/AIDS and nutritional counselling for infant feeding.
Assessment of overall health sector response and capacity
The Democratic Republic of the Congo was among the first African countries to design and implement a programme for HIV/AIDS awareness and prevention in the early 1980s. In 1987, the government established the National AIDS Control Programme to lead the fight against a rapidly increasing epidemic. However, progress was interrupted by the political and civil crisis that broke out in the mid-1990s. In 1999, a National Strategic Plan for an integrated response to HIV/AIDS covering the period 1999–2008 was adopted, including prevention, care and interventions related to the provision of antiretroviral therapy and essential drugs to treat opportunistic infections. A National Health Sector Plan for HIV/AIDS 2002–2004 was also developed. With the end of hostilities and the establishment of a transitional government in 2003, the Democratic Republic of the Congo has witnessed a renewed commitment to the fight against the disease. Since June 2002, a joint public-private initiative piloted by the government has trained health workers, strengthened laboratory capacity and begun procuring generic antiretroviral drugs. The approach is multi-sectoral. In January 2005, the Democratic Republic of the Congo finalized its National Strategic Plan for Scaling Up Access to Antiretroviral Therapy for the Period 2005–2009. The Plan includes strategies for training additional health workers to deliver antiretroviral therapy, expanding prevention and care facilities, strengthening the capacity of national laboratories and improving the procurement and supply management systems for antiretroviral drugs and other supplies. A total of 74 health workers had been trained by June 2004 to deliver antiretroviral therapy in accordance with national standards, mostly in Kinshasa, the capital; and 276 had been trained by September 2005. Coverage of services for voluntary counselling and testing and preventing mother-to-child transmission has expanded. Laboratory facilities for CD4 count are available in Kinshasa, Lubumbashi and Mbuji Mayi. Efforts have been made to expand behaviour change communication with the support of a variety of communication channels.
Critical issues and major challenges
Many years of civil unrest have damaged the health care delivery system. The country is large, has a sizeable mobile population and health care services are inadequately decentralized. There is a severe shortage of human resources trained to deliver antiretroviral therapy. Access to antiretroviral therapy is limited in many provinces. Systems for procurement and supply management of drugs are inadequate, and the cost of treatment remains high. Coordinating mechanisms and monitoring and evaluation systems need to be strengthened. Rapidly scaling up HIV prevention, treatment and care requires accelerating the training of health workers, expanding services for voluntary counselling and testing and preventing mother-to-child transmission, reducing the cost of antiretroviral drugs and diagnostics, extending coverage of services to rural areas and reinforcing synergy among the activities of various partner organisations.
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HIV/AIDS Organisations
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 National Programme against AIDS (Programme National de Lutte Contre le Sida) |
| Contact person: |
Dr Francois Lepira |
Tel: |
+243 88 016 44 |
| Location: |
B.P. 5806
Kinshasa, Democratic Republic of Congo |
Fax: |
+243 88 436 75 |
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| What we do: |
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| Espoir , Vie & Solidarite (EVIS) |
| Contact person: |
Dominique Mbuyi |
Tel: |
+243 09 98 412 745 |
| Location: |
Rue Melele no. 27 3eme etage, QuartierYolo-Nord/Kalamu
Kinshasa 6164 Kin 6, Democratic Republic of Congo |
Fax: |
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| What we do: |
Supporting orphaned and vulnerable children and their families; fundraising; awareness. |
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| Central Network of AIDS Service Organisations (CANASO) |
| Contact person: |
Henri Mukumbi |
Tel: |
+243 68 57 01 |
| Location: |
B.P. 9030
Kinshasa, Democratic Republic of Congo |
Fax: |
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| What we do: |
Network of HIV/AIDS service organisations in nine Central African countries: Burundi, Cameroon, Congo, Gabon, Equatorial Guinea, Central African Republic, Democratic Republic of Congo, Rwanda and Tchad. Its mission is to enhance the community response to HIV/AIDS in Central Africa by promoting the development and existence of sustainable and effective country networks that provide leadership and capacity building in advocacy, programme development, and enhanced greater involvement of people living with HIV and AIDS. |
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| Association Femmes Plus |
| Contact person: |
Philomene Wenge |
Tel: |
+243 99 111 62 / 98 20 22 69 |
| Location: |
B.P. 12605
Kinshasa 1, Democratic Republic of Congo |
Fax: |
+243 88 436 75 |
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| What we do: |
Medical care; advice; training; home and hospital visits; counselling; advocacy and awareness campaigns; material support; income generation. |
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| Society for Women and AIDS in Africa (SWAA) - DRC |
| Contact person: |
Aimé Mwadi Kadi |
Tel: |
+243 88 008 40 |
| Location: |
B.P. 2556
Kinshasa 1, Democratic Republic of Congo |
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| What we do: |
Training; home and hospital visits; counselling; advocacy and awareness campaigns. |
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| UN Country Co-ordinator |
| Contact person: |
Pierre Somse |
Tel: |
+243 81 88 008 40 |
| Location: |
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Fax: |
+243 224 36 75 |
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| UN Theme Group on HIV/AIDS, Chair |
| Contact person: |
Mr Félix Bamezon, WFP |
Mobile: |
+243 81 700 6710 |
| Location: |
Immeuble Losonia 6194
Bd du 30 juin – BP7248
Kinshasa, Democratic Republic of Congo |
Fax: |
+243 81 30 10 482 |
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+243 81 30 10 481 |
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| UNAIDS Regional Support Team for West and Central Africa |
| Contact person: |
Dr Meskerem Grunitzky Bekele, director |
Tel: |
+221 869 06 64 |
| Location: |
P.O. Box 5748
Dakar, Senegal |
Fax: |
+221 869 06 80 |
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| Sources: |
- The Presidents Emergency Plan for AIDS Relief (PEPFAR)
- The World Bank
- World Health Organization
- United Nations Educational, Scientific and Cultural Organization (UNESCO) Country Profiles
- United Nations Population Division, Department of Economic and Social Affairs. 2005. “World Population Prospects: The 2004 Revision.” New York.
- The Joint United Nations Programme on HIV/AIDS (UNAIDS) |
Treatment Map
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| Adult HIV Prevalence Rate (%): |
3.2% |
| No. Of People living with HIV/AIDS: |
1 million |
| No. Of HIV Testing & Counseling Sites: |
184 |
| No. Of People in need of ART: |
209,000 |
| No. Of People 0-49 years On ART: |
6,695 |
| No. Of Sites Reportedly Distributing ART: |
70 (28 public sector, and the others in the private sector or supported by nongovernmental organizations. Access remains limited, covering only 18 of 515 districts as of September 2005). |
| No. Of People on ART Public Sector: |
n/a |
| No. Of People on ART Private Sector: |
n/a |
| No. Of People on ART in Non-Governmental Programmes: |
n/a |
| No. Of People Expected to be on ART (2006 End): |
n/a |
| Front Line Drug Regimen: |
stavudine + lamivudine + nevirapine, also known as Triomune; or stavudine + lamivudine + efavirenz |
| *PMTCT Regimen: |
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| HIV/AIDS Fund Disbursements: |
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| Total Funds Disbursed By The Global Fund as of Sept. 2006: |
US$60,493,473 |
| Total Funds Disbursed By The World Bank Multi-Country HIV/AIDS Programme (MAP) as of Sept. 2006: |
US$102 million |
| Total Funds Disbursed By PEPFAR During 2005 Fiscal Year: |
nil |
Indicators
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| Demographics (United Nations Population Fund): |
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| Population: |
57,549,000 |
| Population aged 15-59: |
27,891,000 |
| Urban population: |
18,845,000 |
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| Under 5 mortality per 1000 births: |
212 |
| Male life expectancy: |
42 years |
| Female life expectancy: |
47 years |
| Combined average life expectancy: |
44.5 years |
| Combined average life expectancy 1975-1980: |
47.8 years |
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| Education (UNESCO, 2004): |
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| Males with secondary education as percentage of secondary school-age youths: |
n/a |
| Females with secondary education as percentage of secondary school-age youths: |
n/a |
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| Literacy rates (UNESCO, 2004): |
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| Percentage of literate males aged 15 or older: |
n/a |
| Percentage of literate females aged 15 or older: |
n/a |
| Combined literacy rate for aged 15 or older: |
n/a |
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