Malawi is a country of nearly 13 million people located in the Rift Valley between Mozambique, Zambia, and Tanzania. The first case of AIDS in Malawi was detected in 1985, and in 1988 blood donors in Malawi had an HIV seroprevalence between 15-30%. The results of a longitudinal study conducted in antenatal clinics in Blantyre demonstrate a linear increase in HIV seroprevalence in this population from 2.0% in 1985 to 25.9% in 1991. HIV prevalence increased more slowly thereafter to 32.8% by 1996. AIDS is now the leading cause of death in Malawi.
At the end of 2001, UNAIDS estimated that out of a population of 11 million, 850,000 Malawians were living with HIV/AIDS and 56.4% of those infected were women. Heterosexual transmission is believed to account for over 90% of HIV infections in Malawi. Mother-to-child transmission (MTCT) of HIV represents 9% of infections, and transmission via unsafe blood products is about 1%.
The devastating consequences of the HIV epidemic in Malawi cannot be overstated, especially given the preexisting poverty and limited public health and medical care available. In 2000, GNP per capita was US $170/year, well below other Sub Saharan Africa countries. Life expectancy at birth is currently estimated to be 36.6 years for men and 37.6 years for women. Infant mortality is 104/1000 live births, and under five mortality is 189/1000 live births. At the end of 2001, UNAIDS estimated that 470,000 AIDS orphans (ages 0 to 14) were living in Malawi.
CFID Collaborations in Malawi
In 1989, UNC faculty were invited by the Malawian government to help the country develop STI treatment protocols, and UNC has been working in Malawi ever since. In 1999 UNC partnered with the Malawi Ministry of Health to establish UNC Project−Malawi, a research, care and training facility in the capital city of Lilongwe.
The mission of UNC Project−Malawi is to identify innovative, culturally acceptable, and relatively inexpensive methods of reducing the risk of HIV/STI and infectious disease transmission through research; strengthen the local research capacity through training and technology transfers; and improve patient care for the people of Malawi.
UNC Project-Malawi operates through Tidziwe Centre at Kamuzu Central Hospital. "Tidziwe" is a Chichewa word meaning "we should find out." The center is a two-story, 17,500 sq ft building that includes outpatient and research exam and counseling rooms, a state of the art laboratory, medical library with satellite web connections supporting journal access, a lecture hall and classroom with teleconferencing capacity, a data management area with remote and local data entry capacity, secure data storage space, a pharmacy and dispensary, and administrative and community activity office space. UNC Project employs medical and clinical officers, nurses, laboratory and pharmacy technicians, data officers and administrative and logistical support staff.