Mozambique faces major challenges to controlling its HIV epidemic, with more than 2 million people living with HIV – 12.6% of the adult population. Since 2019, Abt has led the USAID-funded Efficiencies for Clinical HIV Outcomes (ECHO) project to help the Mozambican government accelerate its HIV response and control the epidemic in four provinces: Manica, Niassa, Sofala, and Tete.
ECHO works with the government and communities to improve the reach and quality of HIV and related services such as tuberculosis and cervical cancer screening. In its first year, ECHO achieved significant results, including:
- Increasing the number of people living with HIV receiving life-saving antiretroviral treatment from 207,753 to 246,256
- Increasing the number of people at risk for contracting HIV who receive prevention drugs (pre-exposure prophylaxis) from 45 in the previous year to 2,109
- Providing treatment to 22,595 pregnant women living with HIV to prevent transmission to their babies
- Increasing one-month adherence to HIV treatment from 58% to 90% and three-month adherence from 74% to 89%
- Increasing the percentage of HIV patients screened for TB from 75% to 96%
- Launching cervical cancer screening services and screening 49,387 women
To achieve its results, ECHO implements a variety of strategies in collaboration with the Mozambican government and communities. The project’s early success can be attributed in great part to diligent data use and rapid roll out of effective strategies, from improving the skills of staff at 148 clinics to working with community workers to ensure patients keep appointments.
ECHO acted quickly to adapt to the COVID-19 pandemic and avoid patient loss. Fears of COVID-19 infection led to a drop in appointments at health clinics. This could have led to increasing numbers of HIV patients abandoning treatment and a decrease in new patients identified and placed on treatment. ECHO worked with the Mozambican government to develop, approve, and implement alternate strategies to ensure that people living with HIV could continue receiving treatment. In just six months, ECHO helped 70 clinics distribute antiretroviral treatment to 15,300 patients. The project helped transition 191,489 patients from a one-month to a three-month supply of antiretrovirals, reducing trips to clinics to pick up medication. That decreased the risk of contracting COVID-19 and increased the odds of adherence to treatment.
ECHO will continue to accelerate these gains to ensure that more Mozambicans living with HIV can begin and maintain treatment, lead healthy and productive lives, and help bring the HIV epidemic under control.