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Malawi, nicknamed ‘the warm heart of Africa’, is among the smallest countries in Africa with a population of roughly 17 million. Bordered by Zambia, Tanzania and Mozambique, one third of the country is covered by Lake Malawi. Malawi is one of the world’s least developed countries and is facing difficulties developing its economy, education and healthcare system. A high prevalence of HIV/AIDS has significant impact on the population and the government is heavily reliant on dwindling levels of foreign aid. Malawi has a life expectancy of only fifty years, with more than ten percent of the population living with HIV/AIDS.

Tuberculosis in the country

Malawi is one of the few countries with more casualties to the combination of HIV and TB, than of TB alone. After an increase in TB mortality around 2007-2008, the rate is now declining, the disease by itself now claims 2300 deaths annually as well as 6600 deaths due to a combination of HIV and TB.

KNCV Activities in the country

KNCV helped improve the procurement and supply chain management of TB drugs in which KNCV offered long term assistance.

KNCV built local knowledge and helped to develop systems for TB drug forecasting, ordering drugs, monitoring warehouses and drug issuing facilities.

Malawi is a country where the Challenge TB program is active. Challenge TB is USAID’s flagship global mechanism for implementing USAID’s TB Strategy and is led by KNCV Tuberculosis Foundation, who also led USAID’s previous TB Control projects TB CARE I, TB CAP and TBCTA.

In 5 districts, Committees for Infection Prevention and Control where trained to introduce the FAST strategy for active case-finding.

2,574 healthcare workers including laboratory staff, health surveillance assistants, nurses, clinicians, ward clerks, anti-retroviral treatment clerks, and TB officers were trained.

Malawi’s National TB Reference Laboratory, which had not functioned since September 2015, was almost fully rehabilitated and handover is planned for April 2017. As part of the rehabilitation, KNCV supported the National TB Program to revise national level guidelines, the national laboratory strategic plan, and the methods needed to conduct external quality assurance of laboratories. We also built the capacity of laboratory staff on drug-susceptibility testing, TB culture and identification, and AFB microscopy.

Two teams were installed in Blantyre and Lilongwe to train and mentor healthcare workers on TB in local TB and HIV facilities. These teams successfully trained healthcare workers to better screen and diagnose patients. We built the capacity of people in five districts on infection control, and the scale-up of FAST (Finding, Actively, Separating, and Treating), a strategy to increase active case-finding and prevent infection at health facilities.