Ciheb’s work in Malawi is building health systems capacity and expanding prevention efforts for HIV, tuberculosis (TB), and COVID-19. The country program employs 40 staff: 27 are based at its country office in Lilongwe, two are seconded to the Ministry of Health headquarters, and 11 are in four referral hospital laboratories in the northern, central, eastern, and southern regions. In addition to supporting HIV and TB PEPFAR programming, Ciheb’s work supported the activation of 11 molecular labs to conduct COVID-19 polymerase chain reaction platform (PCR) tests for the country and facilitated the training of 66 laboratory technologists to perform the tests.
In early 2020, Ciheb established its Malawi office and has been steadily growing its operations in the country. Ciheb Malawi’s impact can be seen through its efforts to strengthen laboratory infrastructure, data utilization for decision making, the training of human resources, quality management systems, and sample transportation.
Accelerating Malawi’s PEPFAR Laboratory Logistics and Infrastructure for Quality (AMPLIFY). This project supports the Ministry of Health with the goal of improving the efficiency, capacity, and quality of laboratory services in Malawi. Specific areas of focus include expanding a cost-effective national sample transport system, expanding access to quality HIV diagnostics, supporting laboratories to achieve accreditation, and building the capacity for COVID-19 sample transport and testing.
A recent significant achievement for the project was the development of the Sample Tracking and Results Transmission (STaRT) mobile application. The app is used to effectively track, monitor, and report events regarding the pickup and delivery of biological samples. A pilot GPS tracking program will also improve the monitoring capabilities of samples.
In September 2020, Ciheb continued to offer technical support to the Ministry of Health regarding viral load testing in all 10 molecular labs and 101 GeneXpert and mPIMA sites. Ciheb tested 48,562 viral load samples and found that 95% met the 95-95-95 target for viral suppression (<1000 copies/mL). Six of the 28 districts in Malawi had attained 95% or greater viral load suppression: Thyolo, Mchinji, Phalombe, Zomba, Machinga, and Kasungu.
Ciheb also continued its support of early infant diagnosis (EID) testing. Out of 3,096 EID samples tested in September 2020, the positivity rate was 6.8%.
The project successfully trained 66 lab technicians to conduct COVID-19 PCR testing in molecular laboratories that conduct HIV PCR tests. The project collaborated with the US Centers for Disease Control and Prevention (CDC) and Riders for Health (RFH) to develop two COVID-19 sample transport models for obtaining samples and delivering them to testing labs.
AMPLIFY is supporting the national sample transportation system in all 28 districts (covering 662 health facilities), using RFH’s services for delivery. Between February 1-March 31, 2020, RFH transported 48,900 samples from health facilities to testing labs and 41,298 results from testing labs back to the health facilities.