'An AIDS success in Africa'
That's how The New York Times described gains by the Centre for Infectious Disease Research in Zambia, where CARE Fund dollars are at work
"On the outskirts of Lusaka, I witnessed this miracle: A man with AIDS, who'd arrived at the clinic skeletal and hopeless, within weeks was triumphantly pushing his own wheelbarrow back home... Those who kissed death now embrace life, lifting wheelbarrows that had once been their hearse."
When Mary Fisher told that story in a packed Capitol Hill chamber in spring 2006, she gave the miracle a name: the Centre for Infectious Disease Research in Zambia (CIDRZ). A non-governmental organization working in partnership with the Zambian government and the University of Alabama at Birmingham, CIDRZ has begun to turn the tide against AIDS in Zambia, where one in six people is HIV-positive.
CIDRZ was conceived by a handful of Zambian and U.S. physicians who met at the University of Alabama at Birmingham (UAB). To overtake AIDS in Zambia, they believed, research and treatment would have to move as quickly as the virus itself. That meant designing CIDRZ with its research staff alongside its care staff: Clinicians would develop new concepts for treatments, researchers would study their effectiveness, and newly-proven treatments could be swiftly shared with patients.
With UAB as its sponsor and the Zambian government as its partner, CIDRZ was established. Within two years, the center was internationally renowned for its work; clinical trials were underway, a laboratory was built, and CIDRZ was soon operating one of the largest programs to prevent mother-to-child HIV transmission in the developing world.
In 2003, the United States funded a new, $15-billion President’s Emergency Plan for AIDS Relief (PEPFAR). Zambia was named one of its 15 "focus countries," and CIDRZ was an early grantee. In partnership with the Zambian government, and with the support of UAB, CIDRZ has expanded to 90 clinical and research facilities around Lusaka.
To ransom Zambia's future, CIDRZ battles HIV/AIDS on many fronts:
- Its Prevention of Mother-to-Child Transmission (PMTCT) program has tested more than 300,000 women and provided those who were HIV positive with medicines to prevent transmission of the virus to their babies. CIDRZ colleagues were invited to present their groundbreaking research on PMTCT and other topics at the 2006 International AIDS Conference in Toronto.
- Its antiretroviral therapy (ART) program has enrolled more than 70,000 children and adults into long-term HIV/AIDS care and started nearly 50,000 on ART. A Centers for Disease Control official called CIDRZ's ART program "number one" among those PEPFAR funds.
- Its pediatric program has enrolled children in ART, and studied the use of ART with children, on a scale unprecedented in the developing world. It provides medications and monitoring services free for children, and is exploring ways to make facilities and procedures more child-friendly.
- CIDRZ researchers conduct ongoing research and clinical trials in critical areas where HIV/AIDS intersects with other perils to Zambian children's health, including malnutrition and tuberculosis.
Since CIDRZ's ART program launched, Lusaka's overall mortality rate has declined by more than half. And by mid-2007, CIDRZ expects to exceed 50,000 adults and children on antiretroviral therapy — a pace and effectiveness unrivaled anywhere.
As CIDRZ has grown to meet the community's needs, it has outgrown its facilities. Critical functions are spread over four separate buildings, none adequate to their task. Staff leaders are removed from those with whom they must work. Such inefficiencies carry steep costs.
Mary Fisher has long supported CIDRZ through the CARE Fund. In spring 2006, she volunteered to head a capacity-building campaign called ZAMBIA FIRST. Its goal: to create a single base of operations from which CIDRZ can pursue its essential research, expand its life-saving treatment — and extend the benefits of both throughout Zambia and sub-Saharan Africa.
CIDRZ plans to build on land in Lusaka between the University of Zambia, a historic partner, and Kalingalinga, a high-density neighborhood with a high burden of HIV disease. The blueprint will conform to CIDRZ founders' philosophy of locating research and service delivery close to each other for easy collaboration.
In the next two years, ZAMBIA FIRST aims to raise US$10,000,000. Of this amount, US$600,000 already has been pledged; development will begin when US$2,500,000 has been pledged. There is no time to waste, CIDRZ's leaders say: According to some projections, by 2014 the ranks of AIDS orphans in Zambia could reach 1 million. Speaking to journalists at the International AIDS Conference, Mary Fisher distilled the urgent needs of all Zambia's children into a single tableau: a mother and a child.
"On a low porch near an open fire over which thin stew is simmering, sits a tiny woman, shivering in the heat as she wastes away. Her mother has given up all hope for her. Her husband is angry at her wasting; he beats her. She pulls her newborn child close to her emaciated breast which gives a moment of comfort but no food. I know this woman. I have held her in my arms. I’ve cradled her infant son, knowing his short future. And I had nothing to offer that would save either of them."
CIDRZ offers hope for Zambia — hope of turning the tide against HIV/AIDS.
Updated April 2007; originally published in the Mary Fisher CARE Fund newsletter, December 2006.
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