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HIV/AIDS info cable

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  • Christine Chumbler
    PREVALENCE ESTIMATES /usr1/tel2/./03/12/10/768486m ********* LILONGWE 1283 - XXSECTION 01 OF 02 ********* N VZCZCAID8190 UNCLASSIFIED ... ACTION OFFICE(S):
    Message 1 of 1 , Dec 11, 2003
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      PREVALENCE
      ESTIMATES


      /usr1/tel2/./03/12/10/768486m
      ********* LILONGWE 1283 - XXSECTION 01 OF 02 *********

      N VZCZCAID8190
      UNCLASSIFIED
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      ACTION OFFICE(S): !AFRAA
      INFO OFFICE(S): AFRSA AFRSD ASIMMONS-BENTON BBUCKLEY
      BLEAVITT CHEANDERSON CWTHAGELMAN DABUSTAMANTE
      DCHAAA DCHAOFDA DHAJJAR DMENDELSON
      DSKORIC DWILSON EGATWID FSHANKS GGRIGSBY
      GHAA GHHN GLYON-POWERS HCABLE IMACNAIRN
      JBRAUSE JHASSE JVORGETTS KBROWN KENTHOWARD
      KPLIKAITIS KWEED LCOUGHLIN LLANDIS
      LPETERSEN MCACHAPER MCAUDLE MEWARD
      MJENNINGS MYARRINGTON PEBALAKRISHNAN
      PMOHAN PPCP RBERGER SANAELE SMCCLURE
      TRASH WWHELAN
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      PAGE 01 LILONG 01283 01 OF 02 101125Z
      ACTION OES-00

      INFO LOG-00 NP-00 AF-00 AID-00 AMAD-00 EVG-00 CIAE-00
      INL-00 DODE-00 DOEE-00 DOTE-00 SRPP-00 MEDE-00 EB-00
      FAAE-00 UTED-00 VC-00 HHS-01 TEDE-00 INR-00 L-00
      VCE-00 NASA-01 AC-00 DCP-01 NSAE-00 NSCE-00 PM-00
      ACE-00 SGAC-00 SP-00 SS-00 TEST-00 T-00 PMB-00
      SAS-00 /003W
      ------------------CDE1C8 101125Z /38
      R 101115Z DEC 03
      FM AMEMBASSY LILONGWE
      TO SECSTATE WASHDC 9231
      DEPT OF HHS WASHDC
      CDC ATLANTA

      UNCLAS SECTION 01 OF 02 LILONGWE 001283


      INFO USMISSION GENEVA
      SOUTHERN AFRICAN DEVELOPMENT COMMUNITY

      STATE FOR OES, AF/S
      AID FOR AFR/AA/AIDW AND BUREAU FOR GLOBAL HEALTH

      E.O. 12958: N/A
      TAGS: KHIV, TBIO, TSPL, MI
      SUBJECT: MALAWI -- 2003 HIV/AIDS PREVALENCE ESTIMATES

      SUMMARY
      -------
      1. ACCORDING TO STATISTICS PRESENTED BY THE NATIONAL
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      PAGE 02 LILONG 01283 01 OF 02 101125Z
      AIDS COMMISSION ON DECEMBER 1, THE 2003 OFFICIAL
      ESTIMATE OF HIV/AIDS PREVALENCE IN ADULTS AGED 15 TO 49
      IS 14.4(WITH A RANGE OF 12 TO 17). THIS PREVALENCE
      REPRESENTS ABOUT 760,000 (630-910,000) INFECTED ADULTS.
      AN ADDITIONAL 70,000 CHILDREN UNDER THE AGE OF 15 AND
      60,000 ADULTS OVER THE AGE OF 50 ARE ALSO INFECTED.
      ALTHOUGH INFECTION RATES APPEAR STATISTICALLY STABLE
      OVER THE LAST 7 YEARS, THE PANDEMIC IS NOT STATIC. AN
      ESTIMATED 86,000 AIDS DEATHS AND 110,000 NEW INFECTIONS
      OCCURRED IN 2003, AND ROUGHLY 170,000 PERSONS NEED ANTI-
      RETROVIRAL DRUGS. WHILE THE NUMBERS ARE STAGGERING, THE
      NATIONAL AIDS COMMISSION'S (NAC) LEADERSHIP AND
      COMMITMENT TO PRODUCING INCREASINGLY ACCURATE HIV/AIDS
      ESTIMATES FOR MALAWI, WHICH THEY ARE WORKING AT
      PRODUCING INDEPENDENTLY OF INTERNATIONAL EXPERTS, IS
      ENCOURAGING. END SUMMARY.

      2. NATIONAL HIV PREVALENCE ESTIMATES HAVE BEEN PRODUCED
      IN MALAWI WITH THE ASSISTANCE OF INTERNATIONAL EXPERTS
      SINCE 1999. THIS YEAR'S ANALYSIS INCLUDED THE USE OF AN
      UPDATED MODELING METHOD AND IN-COUNTRY CAPACITY BUILDING
      SEGMENT, THE GOAL OF WHICH WAS THAT MALAWI WILL PRODUCE
      ITS OWN ESTIMATES IN THE NEAR FUTURE. THIS STRATEGY
      DEMONSTRATES THE LEADERSHIP AND COMMITMENT OF NAC TO
      DEVELOPING THE MOST ACCURATE HIV/AIDS ESTIMATES POSSIBLE
      FOR MALAWI. CDC PROVIDES ONGOING FINANCIAL AND
      TECHNICAL ASSISTANCE TO MALAWI AS A PART OF THE AGENCY'S
      GLOBAL AIDS PROGRAM; CDC AND THE USAID-FUNDED POLICY
      PROJECT PROVIDED DIRECT TECHNICAL SUPPORT TO THE
      DEVELOPMENT OF THE NATIONAL ESTIMATES.

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      PAGE 03 LILONG 01283 01 OF 02 101125Z
      WHAT THE NUMBERS ARE SAYING
      ---------------------------
      3. THE NATIONAL ESTIMATES EXERCISE IN MALAWI IN 2003
      PROVIDES ESTIMATES OF HIV PREVALENCE, NUMBER OF PERSONS
      LIVING WITH HIV/AIDS, NUMBER OF NEW CASES OF HIV, NUMBER
      OF AIDS-RELATED DEATHS, AND NUMBER OF HIV/AIDS ORPHANS.
      THE ESTIMATED HIV/AIDS PREVALENCE IN ADULTS (AGED 15 TO
      49 YEARS) IN MALAWI WAS 14.4IN 2003 WITH A RANGE OF
      12-17; THIS LEVEL OF INFECTION HAS BEEN STABLE FOR THE
      PAST SEVEN YEARS. STABLE PREVALENCE DOES NOT SUGGEST
      THAT THE EPIDEMIC IS OVER. THE PREVALENCE RATE
      REPRESENTS 760,000 (RANGE 630,000-910,000) PEOPLE
      INFECTED WITH HIV THIS YEAR. AN ADDITIONAL 70,000
      CHILDREN UNDER THE AGE OF 15 ARE INFECTED AND ABOUT
      60,000 ADULTS OVER THE AGE OF 50 ARE ALSO INFECTED, FOR
      A TOTAL OF ALMOST 900,000 PERSONS HIV POSITIVE.
      EXAMINATION OF TRENDS IN LILONGWE OVER THE PAST FEW
      YEARS HAS REVEALED A DECLINE IN PREVALENCE IN ALL ADULTS
      AND AMONG YOUNG ADULTS, 15-24 YEARS OF AGE. THIS TREND
      HAS NOT BEEN SEEN IN OTHER PARTS OF THE COUNTRY. CDC
      AND THE NAC HOPE THAT FURTHER STUDY USING SECOND-
      GENERATION SURVEILLANCE APPROACHES WILL PERMIT
      MEANINGFUL CONCLUSIONS ABOUT THIS FINDING.

      4. PREVALENCE REMAINS TWICE AS HIGH IN THE SOUTH AS IN
      THE CENTRAL AND NORTH REGIONS OF MALAWI, AND TWICE AS
      HIGH IN URBAN SETTINGS AS IN RURAL AREAS. AN ESTIMATED
      110,000 NEW HIV INFECTIONS OCCURRED IN 2003. OVER
      25,000 NEW HIV INFECTIONS ARE ESTIMATED TO HAVE OCCURRED
      IN CHILDREN 0 TO 14 YEARS. AN ESTIMATED 170,000 PERSONS
      WILL NEED ANTI-RETROVIRAL DRUGS. AIDS HAS TRIPLED
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      ANNUAL DEATHS IN THE 15-49 YEAR AGE GROUP. ABOUT 80,000
      PREGNANT WOMEN COULD BE TREATED WITH ANTI-RETROVIRAL
      DRUGS TO PREVENT MOTHER-CHILD HIV TRANSMISSION. AN
      ESTIMATED 650,000 ORPHANS (AGED 0 TO 14) WERE LIVING IN
      MALAWI IN 2003, 45 PERCENT OF THOSE DUE TO HIV/AIDS.

      PRODUCTION OF PREVALENCE ESTIMATES
      ----------------------------------
      5. MALAWI HIV/AIDS ESTIMATES 2003 WERE PRODUCED IN
      MALAWI WITH THE ASSISTANCE OF THE UNITED STATES AGENCY
      FOR INTERNATIONAL DEVELOPMENT (USAID) -FUNDED POLICY
      PROJECT, BY A WORKING GROUP INCLUDING THE NATIONAL AIDS
      COMMISSION (NAC), MINISTRY OF HEALTH AND POPULATION
      (MOHP), MINISTRY OF ECONOMIC POLICY AND DEVELOPMENT,
      CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)-MALAWI,
      UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT
      (USAID), THE USAID-FUNDED POLICY PROJECT, UNIVERSITY OF
      MALAWI SCHOOL OF MEDICINE, NATIONAL STATISTICS OFFICE,
      WORLD HEALTH ORGANIZATION (WHO), UNAIDS, MALAWI
      GOVERNMENT OFFICE OF THE VICE PRESIDENT, FAMILY HEALTH
      INTERNATIONAL, BANJA LA MTSOGOLO, AND THE MALAWI AIDS
      COUNSELING AND RESOURCE ORGANIZATION. CDC- MALAWI
      PROVIDED FINANCIAL AND TECHNICAL ASSISTANCE TO NAC IN


      UNCLASSIFIED








      NNNN

      ********* LILONGWE 1283 - XXSECTION 02 OF 02 *********

      N VZCZCAID8191
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      PAGE 01 LILONG 01283 02 OF 02 101125Z
      ACTION OES-00

      INFO LOG-00 NP-00 AF-00 AID-00 AMAD-00 EVG-00 CIAE-00
      INL-00 DODE-00 DOEE-00 DOTE-00 SRPP-00 MEDE-00 EB-00
      FAAE-00 UTED-00 VC-00 HHS-01 TEDE-00 INR-00 L-00
      VCE-00 NASA-01 AC-00 DCP-01 NSAE-00 NSCE-00 PM-00
      ACE-00 SGAC-00 SP-00 SS-00 TEST-00 T-00 PMB-00
      SAS-00 /003W
      ------------------CDE1CF 101125Z /38
      R 101115Z DEC 03
      FM AMEMBASSY LILONGWE
      TO SECSTATE WASHDC 9232
      DEPT OF HHS WASHDC
      CDC ATLANTA

      UNCLAS SECTION 02 OF 02 LILONGWE 001283


      INFO USMISSION GENEVA
      SOUTHERN AFRICAN DEVELOPMENT COMMUNITY

      STATE FOR OES, AF/S
      AID FOR AFR/AA/AIDW AND BUREAU FOR GLOBAL HEALTH

      E.O. 12958: N/A
      TAGS: KHIV, TBIO, TSPL, MI
      SUBJECT: MALAWI -- 2003 HIV/AIDS PREVALENCE ESTIMATES

      CONDUCTING 2003 HIV SURVEILLANCE AT SENTINEL ANTENATAL
      CLINICS TO FORM THE BASIS FOR THE NEW ESTIMATES, AND IN
      COORDINATING WORKING GROUP EFFORTS TO GENERATE THE
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      PAGE 02 LILONG 01283 02 OF 02 101125Z
      ESTIMATES AND PRODUCE THE FINAL ESTIMATES REPORT. THE
      USAID FUNDED POLICY PROJECT AND CDC ALSO PROVIDED
      TECHNICAL EXPERTISE AND SUPPORT IN METHODOLOGY AND
      TRAINING IN ANALYTIC SOFTWARE PACKAGES. CDC MALAWI
      FINANCIAL AND TECHNICAL INVESTMENTS IN DEVELOPING THE
      NAC INFORMATICS INFRASTRUCTURE ALSO CONTRIBUTED TO THIS
      PROCESS, AND ADDITIONAL FINANCIAL SUPPORT WAS PROVIDED
      FOR PRINTING AND PUBLICATION OF THE REPORT FOR
      WIDESPREAD DISSEMINATION.

      6. DATA FROM HIV SURVEILLANCE AT SENTINEL ANTENATAL
      CLINICS WERE USED TO PRODUCE HIV PREVALENCE ESTIMATE
      CURVES USING THE EPIDEMIC PROJECTION PACKAGE (EPP)
      SOFTWARE. HIV/AIDS ESTIMATES AND IMPACT PROJECTIONS WERE
      GENERATED USING THE SOFTWARE PACKAGE SPECTRUM. MALAWI
      HAS COLLECTED SENTINEL SURVEILLANCE DATA AT THESE SAME
      SITES SINCE 1994; THIS LONG-TERM COMMITMENT TO HIV
      SURVEILLANCE PROVIDES MALAWI WITH A CLEAR PREVALENCE
      TREND PICTURE. IN 2004 THE MOHP WILL TAKE
      RESPONSIBILITY FOR HIV/AIDS SURVEILLANCE IN MALAWI AND
      WILL CONTINUE TO CONDUCT ANTENATAL CLINIC SURVEILLANCE
      AT THE SAME SITES AS IN PREVIOUS YEARS.

      7. THE ESTIMATES AND PROJECTIONS IN HIV/AIDS IN MALAWI
      2003 WILL BE USED NATIONALLY AND LOCALLY TO ASSIST IN
      PLANNING FOR PREVENTION INTERVENTION AND TREATMENT
      SERVICES AND TO RAISE AWARENESS OF THE DIFFERENCES IN
      HIV/AIDS PREVALENCE, NEW HIV INFECTIONS, NEW AIDS CASES,
      AND AIDS DEATHS BY SEX AND IN HIV/AIDS PREVALENCE BY
      AREA OF RESIDENCE. THE ESTIMATES WILL ALSO BE USED TO
      MONITOR MALAWI'S PROGRESS TOWARDS THE UNITED NATIONS
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      PAGE 03 LILONG 01283 02 OF 02 101125Z
      GENERAL ASSEMBLY SPECIAL SESSION ON HIV/AIDS (UNGASS)
      GOALS AND WILL BE SHARED WITH UNAIDS AND WHO FOR
      INCLUSION IN THE REPORT ON THE GLOBAL HIV/AIDS EPIDEMIC
      2003. UNAIDS AND WHO PLAN TO RELEASE COUNTRY HIV
      PREVALENCE ESTIMATES IN THE REPORT IN THE FORM OF
      RANGES. THIS APPROACH HAS BEEN ADOPTED TO CLARIFY THAT
      THE DATA ARE ESTIMATES AND THAT THEIR ACCURACY IS BETTER
      UNDERSTOOD AS A RANGE COMPARED TO A POINT ESTIMATE.
      MALAWI HAS ALSO DECIDED TO RELEASE NATIONAL ESTIMATES
      INCLUDING RANGES. THE HIV/AIDS PREVALENCE POINT
      ESTIMATES IN THE 2003 REPORT ARE SLIGHTLY LOWER THAN
      THOSE PUBLISHED BY NAC IN 2001, THOUGH WELL WITHIN THE
      SAME RANGE. THIS DOES NOT REFLECT A DECLINE IN THE
      PROPORTION OF MALAWIANS WITH HIV/AIDS. IT IS BELIEVED
      THAT USING UPDATED ANTENATAL CLINIC DATA, UPDATED
      SENTINEL SITE REPRESENTATION ASSIGNMENTS, AND AN UPDATED
      AND MORE ACCURATE MODEL DEVELOPED BY UNAIDS REFERENCE
      GROUP ON MODELING, ESTIMATES AND PROJECTIONS PROVIDED A
      MORE ACCURATE NATIONAL PREVALENCE ESTIMATE. THERE ARE
      PLANS TO REPEAT THE PROCESS OF GENERATING NATIONAL
      ESTIMATES IN 2004.

      COMMENT
      -------
      8. OFFICIAL NAC STATEMENTS REFLECTED OPTIMISM THAT
      HIV/AIDS INFECTION RATES HAVE STABILIZED IN MUCH OF THE
      COUNTRY AND HAVE DECLINED IN LILONGWE. THEY ALSO
      ACKNOWLEDGED BEHAVIORAL STUDIES ARE NEEDED TO DETERMINE
      THE CAUSES OF THESE TRENDS. NONETHELESS, NEARLY ONE
      MILLION PEOPLE LIVING WITH HIV/AIDS IN MALAWI IS AN
      ALARMINGLY HIGH NUMBER. AS A RESULT OF CONTINUED
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      PAGE 04 LILONG 01283 02 OF 02 101125Z
      POPULATION GROWTH, THE NUMBER OF PEOPLE LIVING WITH
      HIV/AIDS, THE NUMBER OF NEW AIDS CASES, AND THE NUMBER
      OF AIDS-RELATED DEATHS ALL CONTINUE TO RISE. ADDITIONAL
      INTERVENTIONS FOR HIV/AIDS PREVENTION AND TREATMENT ARE
      GREATLY NEEDED TO MINIMIZE THE DEVASTATING IMPACT OF
      THIS DISEASE ON MALAWIANS. END COMMENT.

      BROWNING


      UNCLASSIFIED
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