Getting to Zero Deaths

Phased implementation of integrated cryptococcal meningitis mortality reduction programs

Implementing Partners

The Centers for Disease Control and Prevention


The Kingdom of Eswatini

Despite the significant progress that continues to be made in the expansion of ART programs globally, reductions in AIDS-related mortality have slowed in many contexts. Currently an estimated one-third of HIV- positive clients receiving care are living with advanced HIV disease (AHD), defined as a CD4 cell count below 200 cells/μL or WHO stage 3 or 4. These individuals are at increased risk for opportunistic infections and death, often experiencing challenges in continuing to engage in care.

Cryptococcal meningitis (CM), a serious fungal opportunistic infection, is the second leading cause of HIV-related mortality in sub-Saharan Africa, where it accounts for an estimated 15-20% of HIV-related deaths. In order to refocus on AHD mortality the End Cryptococcal Meningitis Death by 2030 Framework was developed by global stakeholders.

Getting to Zero Deaths is a phased project designed within the End CM Deaths Framework and is aimed at optimizing AHD and cryptococcal disease care.

IGC aims to develop an evidence-based and data-driven plan for sustainable and integratedinterventions optimizing CM and AHD care in Eswatini. IGC’s objective are to:

  • Build and strengthen collaborative partnerships and regular communications around AHD and cryptococcal disease activities
  • Map the current AHD and cryptococcal disease cascade of  care  in detail to identify strengths, weaknesses, opportunities, and threats (SWOT analysis)
  • Convene local, regional, and global experts on the optimal achievable care for AHD andcryptococcal disease in the Eswatini context
  • Develop an implementation road map with in-country stakeholders outlining targeted andintegrated interventions to optimize AHD and cryptococcal disease care
  • Strengthen monitoring and evaluation (M&E) tools and reporting within existing M&E systems to ensure continuous and reliable data is available for future program monitoring and improvement