Improving access to quality health care in Zambia is the mission of CIDRZ, an independent, local, non-governmental organisation that has been active in the country since 2001.

For almost two decades, the Centre for Infectious Disease Research in Zambia (CIDRZ) has provided both direct services in healthcare delivery and research in infectious diseases in support of the Government of Zambia’s goal of improving access to high-quality health care.

Over the years, CIDRZ has built up its research expertise in HIV, tuberculous, maternal and child health, enteric diseases as well as several other areas, and can be rightly proud of its many achievements in improving health care provided to the country’s population.

Founded in 2001 as a collaboration between the University of Alabama at Birmingham, the University of Zambia School of Medicine, and the Zambian government, CIDRZ was conceived as a centre to conduct maternal-child HIV transmission research in Zambia. But rather than establish stand-alone HIV research clinics, CIDRZ was determined to conduct locally relevant research studies within the existing health system infrastructure.

In 2011, CIDRZ was incorporated as an independent, Zambian organisation. Today, the organisation has some 800 staff, researchers, trainees and volunteers; affiliates with many universities; and has on-site faculty from Johns Hopkins University, the University of Alabama at Birmingham, and the University of North Carolina.

Improving lives

In 2017, a prominent Zambian internal medicine and infectious disease physician and specialist in HIV prevention, care and treatment, Dr Izukanji Sikazwe, took over the leadership and strategic direction of CIDRZ as Chief Executive Officer. She explains how the organisation’s scope of work expanded over the years.

“While HIV was the prime focus of CIDRZ during its early years, it was recognised that work needed to be expanded to include tuberculosis, a significant cause of death in the country particularly amongst people living with HIV, and later other diseases as well, given the way we were grounded in the communities and health facilities. For example, we now have a very strong enteric division that has spearheaded a lot of work in introducing the rotavirus vaccine in our communities, resulting in the adoption of the rotavirus as part of a vaccination scheme for children in Zambia.”

CIDRZ has also supported the introduction of cholera vaccines into the communities most affected by this endemic disease, monitoring its incidence, and has played a key role in the rollout with a fantastic result – in the most recent rainy season, there was not a single case of cholera recorded, says Dr Sikazwe.

She points out, however, that the biggest achievement of the organisation so far has been its Covid-19 response: “Just before the pandemic breakout in Zambia, our prime concern was how to support our Ministry of Health to continue to provide HIV and TB treatment services to people under our programmes. We wondered how we could provide treatment to hundreds of thousands of Zambians without exposing them to catching the virus, within a health care system that was expected to get overwhelmed.”

She explained that prior to Covid-19 being detected in the country, CIDRZ worked with the facilities to set up a system that would protect these vulnerable people, and set up a number of community initiatives preventing patients from coming to the health facilities, while making sure they continue treatment, freeing health staff to take care of acute Covid-19 cases.

To help handle the increased volume of testing requirements in a country with only three testing sites, CIDRZ offered the capacity of its own internationally accredited laboratory and donated one of its platforms to the government to be deployed in the northern part of the country. The laboratory itself was modified to enable testing for the virus.

“I think the way we handled the Covid crisis has been outstanding. Even now, during the third wave, we are making sure that HIV and TB patients can access health care services even outside the standard settings, freeing health care workers to focus on Covid cases,” Dr Sikazwe affirms.

Local ownership

Not surprisingly, the availability of a human resource capacity that is knowledgeable, to provide the services needed across all health situations, across all parts of Zambia including the difficult-to-get areas, is a pressing concern. More funds will need to be allocated to help alleviate the issue and enhance the role of the CIDRZ in making sure all Zambians have access to adequate health care.

Dr Sikazwe says: “We are diversified in terms of our focus. We seek to find local solutions to the different challenges we are facing, and to float concepts and initiatives to different funders, to support the work with the Ministry of Health to come up with different research activities that can improve the nation’s health.”

She further points out that a looming issue is that of mental health, irrespective of the disease. “With regard to HIV, we still have problems with people getting tested, getting them on treatment and helping them to deal with any mental issues that may lead to alcohol and substance abuse and depression. The main tasks will focus on how to unlock the delivery of mental health services in a setting such as ours, how to de-stigmatise mental issues, how to have sufficient human resources to support this effort.”

This will not come easy given CIDRZ’s other obligations as well as limited funds, Dr Sikazwe admits: “CIDRZ is a local, non-profit organisation. As such, it struggles to compete with large international organisations funded or backed by huge international universities, with well-established procedures and systems and whole machinery in place to support their work. All the funding we receive comes to us through competitive bids and in these, we tend to be disadvantaged against the international, financially robust organisations.”

In concluding, she affirms that CIDRZ will continue to support local ownership of high-quality, complementary and integrated healthcare research and services within the Zambian public health system. “We are a local entity working for local communities and as such, what we have achieved in the last 20 years is truly remarkable.”