Getting to Zero Deaths

Phased implementation of integrated cryptococcal meningitis mortality reduction programs

Implementing Partners

The Centers for Disease Control and Prevention

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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
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