Life changed for Grace Mpande in June 2019 when she received the news that she had tested positive for HIV. Perhaps this news might have been easier to hear for the 34-year-old small-scale merchant, had she not been pregnant at the time. “I became momentarily mute,” she recalls. She had been attending a routine antenatal care visit at the Luangwa Boma Rural Health Center in Luangwa, Zambia, where she lived with her husband and three children. Despite her shock and sadness, she knew she had to make a decision to preserve her life and that of her unborn child.
Grace is one of 1.2 million people living with HIV in Zambia who need lifesaving antiretrovirals and other essential medicines to protect them from opportunistic infections such as tuberculosis. To support the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) goal of achieving an AIDS-free generation, the USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project ensures timely delivery and availability of antiretroviral treatment and commodities for TB preventive therapy across millions of health facilities in over 65 countries. In Zambia, the project has delivered over 20.8 million bottles of tenofovir/lamivudine/dolutegravir (1.6 million bottles of TLD180; 5.7 million bottles of TLD90, and 13.5 million bottles of TLD30), ensuring that people like Grace have access to an uninterrupted supply of antiretroviral medicines.
In the same year as Grace’s was diagnosis, PEPFAR scaled up access to TB preventive therapy for all people living with HIV in Zambia, including pregnant women and children, making the treatment an integral and routine part of the clinical care package for HIV/AIDS. To date, GHSC-PSM has procured and delivered the following commodities for TB preventive therapy: Isoniazid (an antibacterial medicine which reduces the risk of TB infection) for more than 950,000 adults and 100,000 pediatric clients; Pyridoxine (which prevents TB-induced damage to nerves located outside the brain) for more than 780,000 adults; and Rifapentine/Isoniazid to treat active or latent TB in more than 140,000 adult clients.
After her diagnosis in 2019, Grace was initiated on TLD treatment regimen and immediately began TB preventive therapy with Isoniazid and Pyridoxine. Her strict adherence to her treatment regimen paid off. The following year, she gave birth to a beautiful baby girl, born HIV negative. Her story of hope doesn’t end here. In March 2022, laboratory results showed Grace’s viral load (VL) as suppressed and undetectable. This was possible because Grace had uninterrupted access to ARVs. She has maintained this result for the last two years.
“I have been committed to taking my medicines daily because I want to be healthy enough to take care of my children. I have seen other people die prematurely because of weakened immunities. I encourage all clients on ART and TPT to fully adhere to treatment.”
- Grace Mpande, Luangwa Boma Rural Health Centre
Today, as a result of PEPFAR’s unrelenting efforts, there’s hope for Grace and millions of others who have resolved to live a long and full life, regardless of their HIV status.