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 Wednesday 16 June 2010
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Country Profile: Malawi
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AIDS Programmes

National Strategic Framework: 2005–2009

Epidemiological Assessment (UNAIDS):

Major vulnerable and affected groups
Young people 13–24 years old are particularly vulnerable to HIV, especially girls. The HIV prevalence is almost twice as high in urban areas (25%) as in rural areas (13%). High levels of movement among urban, rural, and mining areas facilitate HIV transmission. Mobile groups in Malawi, including truck drivers, sex workers, fishermen and -women and fish traders, migrant and seasonal workers, military personnel, prisoners and refugees, are also vulnerable to the epidemic.

Policy on HIV testing and treatment
The Government of Malawi, through the National AIDS Commission, undertakes to promote and provide high-quality, cost-effective, confidential and accessible voluntary counselling and testing services country-wide, in particular youth-friendly services and services that are adequate and accessible to other vulnerable groups. Voluntary counselling and testing is either confidential or anonymous. The government and the National AIDS Commission further promote and encourage couple counselling and the disclosure of HIV test results to partners, strive to ensure that voluntary counselling and testing services are staffed by adequate numbers of trained counsellors and coordinate and ensure the links between voluntary counselling and testing services and other services related to HIV/AIDS to provide a continuum of prevention, treatment, care, support and impact mitigation. The National AIDS Commission also ensures that HIV testing is routinely offered to all pregnant women attending antenatal clinics unless they specifically choose to decline. The delivery of quality community home-based care is promoted as an essential component of the continuum of care for people living with HIV/AIDS. A National Plan to Scale Up Antiretroviral Therapy has been developed, and antiretroviral therapy has been provided free of charge in the public sector since 2003. The prescription and sale of antiretroviral drugs is regulated to guarantee quality control and to reduce the risk of drug resistance developing through inappropriate use of the drugs. The national Essential Drug List is regularly updated to incorporate essential drugs for HIV/AIDS treatment in accordance with the WHO Model List of Essential Medicines. Infections related to HIV/AIDS are treated according to the national Essential Health Package.

Critical issues and major challenges
As the demand for HIV/AIDS prevention, care and treatment services increases, health sector capacity needs to be built up to scale up provision of services throughout the country. The greatest challenge facing Malawi is a human resource crisis, which has generally created a lack of capacity to deliver health services, especially in rural areas where primary health care is severely compromised. The scaling up of the Essential Health Package has been critically slowed, with only 10% of 617 facilities satisfying the human resource requirements for delivering the Essential Health Package (four professional or technical employees). Staffing is also inadequate to roll out antiretroviral therapy and other services related to HIV/AIDS, including voluntary counselling and testing, treating opportunistic infections and preventing mother-to-child transmission. Drug procurement and supply management systems need to be strengthened, as well as systems for monitoring adherence to treatment and drug resistance. Stigma and discrimination remain present. Nutritional support for people living with HIV/AIDS needs to be assured. Efforts need to be made to ensure greater involvement of people living with HIV/AIDS in the national response. Financial sustainability of the national programme is also a concern.

HIV/AIDS Organisations

  Ministry of Health and Population
Contact person: Tel: +265 1 789 400
Location: P.O. Box 30377
Lilongwe 3, Malawi
+265 1 788 849
  Fax: +265 1 789 431
What we do:

  National AIDS Commission of Malawi
Contact person: Dr Bizwick Mwale, executive director / Dr Owen Kalua, director of programmes Tel: +265 1 727 900
Location: P.O. Box 30622
Lilongwe, Malawi
Fax: +265 1 843 363
What we do: Prevention work; strengthen the capacity of institutions, communities and individuals to stop the spread of the epidemic and mitigate its impact.

  Actionaid - Malawi
Contact person: Tel: +265 1 757 500/04/08
Location: P.O. Box 30735, Lilongwe Fax: +265 1 771 349
What we do: Prevention; care and support, advocacy, outreach; education; counselling.

 Family Health International (FHI)
Contact person: Dr Margaret Kaseje, country director Tel: +265 1 775 106
Location: House City Center
Arwa House, 3rd Floor/ North Wing
Lilongwe 3, Malawi
What we do: Diversified programme of research, education, and services in family health and HIV/AIDS prevention and care.

 Malawi Network of AIDS Service Organisations (MANASO)
Contact person: Tel: +265 01 835 018/46
Location: P.O. Box 2916
Blantrye, Malawi
What we do: Networking; information sharing, training workshops; grants management aimed at building the capacities of community based organisations.

 Malawi Network of People Living with HIV/AIDS
Contact person: Victor Kamanga / George Kampango Tel: +265 1 773 727
Location: Private Bag 377
Lilongwe 3, Malawi
Fax: +265 1 770 194
What we do: Support groups; information; training programmes; conferences.

 National Association of People with HIV/AIDS in Malawi (NAPHAM)
Contact person: Kumbakani Black Tel: +265 1 791 943
+265 1 770 641
Location: Private Bag 355
Lilongwe, Malawi
+265 1 776 343
  Fax: +265 1 791 939
What we do: Home-based care; counselling; education; condom promotion; information; support; advocacy.

 Partners in Hope
Contact person: Tel: +265 01 727 155
Location: P.O. Box 302
Lilongwe, Malawi
What we do: Clinic with programmes for ARVs; HIV prevention; prevention of mother to child transmission; home-based care.

 Population Services International (PSI)
Contact person:   Tel: +265 1 677 345
Location: P.O. Box 529
16 Leslie Road
Blantyre, Malawi
Fax: +265 1 674 138
What we do: Uses social marketing to deliver health products, services and information that enable low-income and other vulnerable people to lead healthier lives.

 Southern African AIDS Training Programme (SAT)
Contact person: Tel: +265 1 774 422
+265 1 774 427
Location: Private Bag B325, Lilongwe 3, Malawi Fax: +265 1 775 351
What we do: Supports community responses to HIV and AIDS through in-depth partnership; networking; skills exchange; lesson sharing in HIV prevention, HIV and AIDS care and support throughout the region.

 Salima HIV-AIDS Support Organization (SASO)
Contact person: George Kanyemba Tel: +265 262 821
Location: PL Bag 18
Salima, Malawi
What we do: Networking; information sharing, training workshops; grants management aimed at building the capacities of community-based organisations.

 Umoyo Network
Contact person: Tel: +265 621 022
+265 621 348
Location: Private Bag 254
Blantyre, Malawi
Fax: +265 624 980
What we do:  Capacity building in reproductive health and HIV/AIDS of local NGOs in Malawi.

 UN Theme Group on HIV/AIDS, Chair
Contact person: Mr Michael Keating, UNDP Tel: +265 1 773 329
Location: Lilongwe 3, Malawi Fax:
What we do: Supports an expanded response and policy advice on preventing transmission of HIV, providing care and support, reducing the vulnerability of individuals and communities to HIV/AIDS.

 UNAIDS Country Co-ordinator
Contact person: Desmond Johns Tel: +265 1 772 603
Location: P.O. Box 30135
Lilongwe 3, Malawi
Fax: +265 1 773 992
What we do: UNAIDS leads, strengthens and supports an expanded response aimed at preventing transmission of HIV, providing care and support, reducing the vulnerability of individuals and communities to HIV/AIDS.

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

Adult HIV Prevalence Rate (%): 14.1%
No. Of People living with HIV/AIDS: 940,000
No. Of HIV Testing & Counseling Sites: 184
No. Of People in need of ART (Dec. 2006): approx. 170-180,000
No. Of People On ART (Sept. 2006): 70,000
No. Of Sites Reportedly Distributing ART (June 2006): 101 in the public sector; 28 in the private sector
No. Of People on ART Public Sector (June 2006): 57,366 in both the public and private sector; no further breakdown exists
No. Of People on ART Private Sector: see above
No. Of People on ART in Non-Governmental Programmes: counted in public estimates
No. Of People Expected to be on ART (2006 End) (Sept. 2006): 80,000
Front Line Drug Regimen (Dec. 2006): stavudine + lamivudine + nevirapine, also known as triomune
*PMTCT Regimen (Dec. 2006): The PMTCT regimen is Nevirapine for both mother and baby but Malawi is nevirapine but Malawi is considering combined ARV regimen for PMTCT and this is yet to be determined. ART is recommended for pregnant women who are eligible based on staging or CD4 counts.

HIV/AIDS Fund Disbursements:
Total Funds Disbursed By The Global Fund as of Sept. 2006: US$49,793,160
Total Funds Disbursed By The World Bank Multi-Country HIV/AIDS Programme (MAP) as of Sept. 2006: US$35 million
Total Funds Disbursed By PEPFAR During 2005 Fiscal Year: nil

Sources: Government of Malawi, UNAIDS


Demographics (United Nations Population Fund):
Population: 12,884,000
Population aged 15-59: 6,185,000
Urban population: 2,211,000

Under 5 mortality per 1000 births: 184
Male life expectancy: 41 years
Female life expectancy: 41 years
Combined average life expectancy: 41 years
Combined average life expectancy 1975-1980: 43.8 years

Education (UNESCO, 2004):
Males with secondary education as percentage of secondary school-age youths: 32 percent
Females with secondary education as percentage of secondary school-age youths: 26 percent

Literacy rates (UNESCO, 2004):
Percentage of literate males aged 15 or older: 75.5 percent
Percentage of literate females aged 15 or older: 48.7 percent
Combined literacy rate for aged 15 or older: 61.8 percent
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