Disease Spectrum & Demand Gap

Infectious diseases, including HIV/AIDS (representing around 65% of all deaths), malaria (12.5%) and tuberculosis (5.9%) continue to be the main drivers of needs in the pharmaceuticals in Zambia[1].

The country is also faced with a high burden of Maternal, Neonatal and Child Health (MNCH) problems, and a growing problem of Non-Communicable Diseases (NCDs), including mental health, cancers, sickle cell anaemia, diabetes mellitus, hypertension and heart diseases, chronic respiratory disease, blindness and eye refractive defects, and oral health problems. Currently, the top 10 causes of morbidity and mortality in Zambia include malaria, respiratory infections (non-pneumonia), diarrhoea (non-blood), trauma (accidents, injuries, wounds and burns), eye infections, skin infections, respiratory infections (pneumonia), ear, nose and throat infections, intestinal worms and anaemia[2].

Diarrheal diseases represent 12.9% of all deaths, which is a major contributor to ill health, hospitals occupancy and mortality in Zambia. In children under 5, it is responsible for an estimated 24,000 annual admissions from which about 1,500 die. Rotavirus infection, which is highly prevalent, is being targeted by introduction of a specific vaccine against it in the Expanded Program on Immunization[3].

Among the too few health facilities in the country not all have Antiretroviral Therapy (ART) services. The Health Facility Census reports that only about 32.1 percent of level 1 and below health facilities provide ART services. This creates a patient facility ratio of about 8000 : 1.

The Government welcomes investors for the growing of medicinal plants (Quinine, Artemisian derivatives etc.)[4].

Major public health problems in Zambia

1)      HIV/AIDS: According to recent annual figures of new HIV infections in Zambia in 2011 stood at 69,000 (out of which 27,000 were young people aged between 15 and 24). Zambia’s estimated HIV/AIDS prevalence of approximately 16% among the 15-to-49-year-old age group makes it one of the countries in Sub-Saharan Africa most affected by the pandemic[5].

2)      Tuberculosis (TB):  The case detection rate for TB in 2009 was 58% and the treatment success rate was 86%. The TB situation has also been exacerbated by the high HIV co-infections, currently estimated at 70% of TB patients and the emerging Multi-Drug Resistant (MDR) TB cases. Zambia has adopted the Stop TB Strategy for the control of tuberculosis.

3)      Malaria: It accounts for over 40% of all health facility visits in Zambia and 20% of maternal mortality.

Need for innovation in treatment

1)      Infection control – the UTH has policies and programs in place but does not seem to be fully up to speed, for example Lusaka Trust Hospital has shown interest in new solutions in respect of infection control[6].

2)      Cardiovascular – there is awareness of the growing problems with NCDs in Zambia, and a main focus for development of both public and private hospitals is cardiovascular diseases.

3)      Oncology – the CDH is looking to enhance, not only the availability of standard care in regional hospitals, but also level of cancer treatment by introducing more advanced equipment such as a linear accelerator.

[1] Gustaf Engstrand, Report on the Health Care Sector and Business Opportunities in Zambia, p.12.

[2] National Health Strategic Plan 2011-2015, Republic of Zambia, Ministry of Health, p.6.

[3] Gustaf Engstrand, Report on the Health Care Sector and Business Opportunities in Zambia, p.12.

[4] Ibid., p.62.

[5] Financing and Business Development Needs of Private Health Care Providers in Zambia (Market Research Report), USAIDS, August 2009, p.3.

[6] Gustaf Engstrand, Report on the Health Care Sector and Business Opportunities in Zambia, p.62.