Zambia Surpasses HIV Treatment Targets but Faces Rising New Infections
Zambia has exceeded global HIV treatment targets, achieving one of the strongest national responses in sub-Saharan Africa. Yet health experts caution that stubbornly high new infections, persistent paediatric treatment gaps and tuberculosis (TB)-HIV co-infections continue to threaten epidemic control.
At a media briefing in Lusaka, Dr Chimika Phiri, HIV Prevention Adviser at the Ministry of Health, confirmed that Zambia had reached 98-98-97 in the UNAIDS 95-95-95 targets.
“This means nearly all people living with HIV know their status, almost all are on treatment, and nearly all on treatment have achieved viral suppression,” Dr Phiri said. “This is a huge national milestone that reflects decades of effort by government, partners and communities.”
Between 2016 and 2021, HIV incidence dropped from 0.6% to 0.3%. While Southern and Lusaka provinces have performed above the national average, others continue to lag behind, underlining the need for tailored, location-specific interventions.
Despite strong progress, children remain the most vulnerable group. Around 18% of HIV-positive children have yet to be identified and started on treatment.
“This is a worrying gap because children represent the future of the country,” Dr Phiri said, stressing the need for innovative strategies.
Mother-to-child transmission also remains a concern, as many women acquire HIV during pregnancy or breastfeeding, leading to new infant infections. Authorities are scaling up prevention programmes to ensure viral suppression among mothers, which virtually eliminates transmission risk.
Adolescents face additional barriers, including limited HIV knowledge and laws requiring parental consent for testing under age 16.
To close gaps, Zambia has revised its minimum HIV service package to ensure consistent quality across facilities. The country is also a member of the Global Alliance to End AIDS in Children by 2030.
In prevention, Zambia has become one of the first countries in the world to roll out injectable PrEP (pre-exposure prophylaxis) outside research settings. A long-acting six-month injection is expected in early 2026.
Tuberculosis remains Zambia’s leading cause of death, with 60,000 cases recorded annually, one-third co-infected with HIV. Drug-resistant TB affects about 2,000 people, though detection rates remain limited.
“Undetected TB cases threaten to undermine overall control efforts,” Dr Phiri warned. “We must strengthen TB-HIV integration and scale up targeted prevention.”
With external funding in decline, government and health leaders are calling on the private sector to fill critical financing and service delivery gaps.
At a stakeholder meeting in Lusaka, Dr Lackson Kasonka, speaking on behalf of Minister of Commerce, Trade and Industry Chipoka Mulenga, urged companies to adopt HIV workplace policies and expand community outreach.
“HIV prevention must be mainstreamed into business operations,” he said. National AIDS Council (NAC) Director General Kebby Musokotwane was more direct: “The survival of Zambia’s HIV programme depends on stepped-up investment and innovation from the private sector. This is not about handouts, but about forging a new partnership.”
He emphasised that businesses stand to benefit directly: “A healthy workforce is critical for productivity. Investing in health is a direct investment in your company’s bottom line.”
The Private Public Dialogue Forum (PPDF) echoed the call for action, highlighting that while the private sector contributes more than 80% of GDP and employs nearly 90% of Zambia’s workforce, its direct support for HIV programmes remains below 7%.
PPDF Director General Andrew Chipwende said workplace programmes already reach more than 10,000 clients and are being digitised to expand access by 2026.
UNAIDS Country Director Isaacs Ahemesah announced the creation of a Health Technical Working Group under PPDF to identify gaps and develop solutions with government. “The President’s vision is that Zambia’s economy should be anchored in the private sector, with government playing a supportive role,” Mr Ahemesah said.
NAC Director of Programmes Katongo Silwizya warned that Zambia’s HIV progress could be undermined without sustained domestic investment. “No business thrives in an unhealthy nation. The fight against HIV requires the private sector to take responsibility,” he said.
While Zambia has reached historic milestones, the road ahead requires stronger prevention, child-focused treatment, TB-HIV integration and robust private sector engagement. Only then, experts say, can the nation achieve its goal of epidemic control by 2026 and build a sustainable path towards an HIV-free generation.
