Young people in Monze and Katete lead efforts to curb down adolescent pregnancies and new HIV infections amid funding cuts

In Zambia’s Eastern and Southern Provinces, adolescents and young people are receiving essential Sexual and Reproductive Health and Rights (SRHR) information and services through the RAPHIZ (Reducing Adolescent Pregnancies and New HIV Infections in Zambia) programme, a United Nations joint initiative of UNAIDS, UNFPA, UNICEF, and WHO, working together under the Together4SRHR Programme to deliver SRHR, HIV and Gender Based Violence (GBV) information and services for adolescents and young people in Zambia. While funding cuts have severely disrupted services such as community outreach activities and GBV response services, young people, health care workers, self-care agents and peer educators have shown remarkable resilience and are calling for stronger support to lead healthy and safe lives.

According to the latest UNAIDS report, AIDS, Crisis and the Power to Transform, there were 11,000 new HIV infections among young people aged 15–24 in 2024 in Zambia. The RAPHIZ programme is helping young people in the two districts challenge harmful sociocultural and gender norms that hinder access to reproductive health care information and services.

Since 2024, the joint programme trained over 50 healthcare workers, 64 community-based volunteers, 36 self-care agents, community facilitators and peer educators to provide integrated SRH, HIV and GBV information and services in Katete and Monze. However, Progress was undermined by the United States Government (USG) aid freeze in January 2025, with an immediate impact on the mental health and wellbeing of young people. An 18-years-old adolescent at Monze Urban Clinic shared his feelings at the time:

“I felt bad when I heard the news about the funding issue. Without condoms and PrEP, I was asking myself how we are going protect ourselves from HIV and STIs, as I didn't know my boyfriend's status and I needed PrEP.'' 

Youth-led outreach and peer-led prevention activities were also heavily disrupted in January 2025, when most community-based workers, whose allowances depended on USG funding, were forced to stop work for three weeks due to funding constraints. A health worker from Chikuni Mission Hospital in Monze described the anxiety caused by the cuts:

“During the funding freeze, there was an issue of retention on HIV treatment. We did not have outreach peers, so we had to send reminders for people living with HIV to attend ART appointments. It starts with people missing one appointment, and then it becomes very difficult to bring them back. At that time, we only had 15 community-based volunteers, and it was simply not enough to respond to the needs of the community.” 

Despite these challenges, young people and peer educators have shown remarkable resilience and dedication to continuing service delivery of essential health services during the aid freeze. In Bweenga Rural Health Centre, Trevor, a 24-year-old peer educator, warned: “If health education stops, people will turn to drug and substance abuse.” He and his peers continued volunteering without financial compensation, often walking long distances to reach the health centre. “We come to the facility every day to support our peers, and we are not paid for our work, but if we don’t come, we deprive the adolescents who depend on us.” He passionately shared.

While ARVs remain available in most facilities, essential commodities such as PrEP (TE), HIV/Syphilis dual test kits, and Determine HIV rapid test kits were critically low or out of stock as of May 2025, pointing to the need for better coordination of supply from provincial to district levels during the crisis. 

While the majority of essential health services had been restored in the health facilities a few weeks after the funding freeze, the UN stepped in to partially address commodity availability issues. UNFPA filled the gaps in supply chain management to ensure that reproductive health commodities, ARVs and other essential medicines reached people in need across the country. This was done through providing third party logistics to Zambia Medicines and Medical Supplies Agency, facilitating delivery of commodities to seven regional hubs across the country. 

The recent disruptions have demonstrated that even with limited resources, community-driven solutions along with sustained partnerships can make a difference, and that young people are willing to lead local responses. However, communities and young people need consistent access to sexual and reproductive health products, even outside of health facilities. The crisis, with its disruptions in supply and services, particularly in rural settings, has created anxiety among those seeking care and placed significant mental and psychological strain on health service providers, community-based volunteers, and young peer educators. The resilience of adolescents and peer educators is not infinite, nor should it be taken for granted. 

“February and March were very stressful. People living with HIV asked many questions we didn’t know how to answer. There was anxiety about what would happen next,” shared a health worker at Chikuni Mission Hospital.

Increased domestic financing, particularly at the local level, and renewed donor support is needed to close the resource gap in the immediate term, particularly for youth-specific prevention tools and services. Continuous supply of commodities like family planning, condoms, PrEP, and HIV self-test kits is also necessary. 

This year’s International Youth Day which is commemorated on 12th August with the 2025 theme, “Local Youth Action for the Sustainable Development Goals (SDGs) and Beyond”, is not only a recognition of the courage and power of Zambia’s young people but also a clear call to action: give them the resources and tools to decentralize the SRHR/HIV/GBV services they need and ensure sustainable access. The views and voices of young people are critical. Through their presence on the ground and their understanding of local realities and needs, young people are the bridge between the community, service providers and those working to ensure universal access to SRHR/HIV/GBV information and services.

To achieve SDG 3 and ensure healthy lives and wellbeing for all, at all ages, we must unite in building locally owned, sustainable solutions to SRHR/HIV service delivery for adolescents and youth—solutions that reflect their needs.