NATIONAL AIDS COMMISSION RESEARCH REPOSITORY

The repository provides open access to research, reports, and publications that inform Malawi's HIV response.

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Malawi Demographic and Health Survey 2024 Final Report
(NSO, 2026-12-10) Malawi National Statistics Office
Demographic and Health Surveys (DHSs) are population-based surveys designed to monitor progress in health service utilization and management to inform decision makers. Since 1992, DHS surveys led by the Malawi National Statistical Office have been conducted in the country in collaboration with the Ministry of Health (MoH), the Public Health Institute of Malawi (PHIM), and other stakeholders. Funds for the 2024 Malawi Demographic and Health Survey (MDHS) were provided by the United States Agency for International Development (USAID); the Government of Malawi; the World Bank; the United Nations Children’s Fund (UNICEF); the United Nations Population Fund (UNFPA); the United Nations Educational, Scientific and Cultural Organization (UNESCO); the United Nations High Commissioner for Refugees (UNHCR); the World Health Organization (WHO); the UK Foreign, Commonwealth and Development Office (FCDO); the KfW Development Bank of Germany; Global Affairs Canada; the European Commission; and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF). Prior to the 2024 MDHS, five rounds of the MDHS—in 1992, 2000, 2004, 2010, and 2015–16—were successfully completed, making this round the sixth in the series. These surveys provide information on mortality, morbidity, nutritional status, disease prevalence, service utilisation, and health-seeking practices at the district, regional, and national levels. The MDHS is an important source of information for measuring the outcomes and impact of health programmes and for developing annual and sectoral plans. The 2024 MDHS provides national estimates of demographic and health indicators that are comparable to data collected in Malawi’s five previous DHS surveys and similar surveys in other developing countries. Data collected in the 2024 MDHS add to the large and growing international database of population-based indicators for Malawi. The 2024 MDHS collected data from a nationally representative sample of approximately 23,000 households from 28 districts and four major cities. The survey interviewed 22,414 households, 20,849 women of reproductive age (15 to 49 years), and 8,583 men age 15 to 54. In addition, children age 0–5 and women age 15–49 were measured for anthropometry, anaemia, and micronutrient , and children age 6–59 months were tested for malaria using malaria rapid diagnostic tests. The 2024 MDHS was also implemented in a special domain of the Dzaleka refugee camp, providing snapshots of the population and the health status of the refugees. This final report provides detailed analyses and results from the 2024 MDHS and presents trends in indicators using data from the previous rounds. The indicators presented include, but are not limited to, total fertility rates, teenage pregnancy, current use of contraception, unmet need for family planning, childhood mortality rates, vaccination rates, nutritional status of children, minimum dietary diversity among children, household possession of insecticide-treated mosquito nets, the prevalence of malaria among children, and knowledge of HIV prevention methods. These data are disaggregated by districts and four major cities, by type of locality, and by selected demographic characteristics including sex, age, education, and household wealth. Findings from this report will support the design, implementation, monitoring, and evaluation of policies and programmes to improve population health in general as well as reproductive, maternal, and child health.
The Malawi National AIDS Spending Assessment (Financial Years 2019/20 - 2021/22)
(National AIDS Commission, 2023-04-10) Malawi National AIDS Commission
Background: This National AIDS Spending Assessment (NASA) report examines HIV expenditure in Malawi from FY 2019/20 to FY 2021/22, applying a globally recognized methodology to track resource flows. Key Findings: Total HIV spending increased from MWK275 billion (US$373 million) in 2019/20 FY to MWK376 billion (US$461 million) in 2021/22 FY, driven by international donors (United States Government, the Global Fund) and Government of Malawi. HIV care and treatment spending rose from MWK148 billion to MWK210 billion, while prevention spending stagnated below recommended levels (25%). In essence, care and treatment accounted for over 55% of expenditure, while prevention spending remained low (7-8%). Personnel costs and medical supplies were key cost drivers of spending. Conclusion: The report highlights sustainability risks due to reliance on external funding, threatening long-term HIV response. Recommendations: Domestic resource mobilization, health insurance, and mainstreaming HIV activities into core budgets are recommended. The government should develop resource mobilization strategies and create budgetary space for HIV costs over the next decade.
Malawi National HIV Prevention Framework (2023-2027)
(National AIDS Commission, 2023-09-16) Malawi National AIDS Commission
As Malawi moves into the second and final half of the implementation of the current National Strategic Plan for HIV and AIDS the country acknowledges that HIV is one of the major challenges being faced. Consequently, through the new HIV Prevention Framework the country is committed to ensuring that all necessary HIV and AIDS control measures are implemented to eliminate AIDS as a public health threat by 2030. The efforts being made by various players in HIV Prevention in Malawi have created favorable environment to achieve this aspiration. Government enacted the HIV and AIDS (Prevention and Management) Act No. 9 of 2018 to create a conducive environment to prevent and manage HIV and AIDS. This is in recognition of the fact that HIV and AIDS prevention and management is one of the key priorities that contribute to one of the enablers of the Malawi Vision 2063 (Human Capital Development). I am pleased that, despite the adverse effects stemming from unfavorable weather conditions, COVID-19 and other economic shocks over the past recent years, Malawi has made tremendous progress towards achieving the global 95:95:95 Fast-Track targets set out in the revised NSP 2023-2027. In addition, recent estimates indicate a continued declining trend in the annual AIDS-related deaths and number of new HIV infections, particularly among adolescent girls and young women. This gives us renewed hope that, despite the existence of resource limitations, together with our implementing partners, we can speed up our efforts towards the removal of AIDS as a public health threat by 2030. This development of the Prevention Framework took place while also revising the NSP 2020-2025 and producing the Health Sector Strategic Plan III 2023-2030 and the discovery of a novel injectable HIV preventive drug, cabotegravir. These, coupled with lessons learned from the previous implementation of the HIV and AIDS Prevention Strategy, will ensure efficient and cost-effective implementation of a well-coordinated HIV and AIDS programmes. Mirroring on the revised NSP, this Prevention Framework emphasizes efficient utilization of available resources and implementation of targeted client-centered interventions to achieve a steep downtrend in the number of new infections and improve the survival and quality of life of People Living with HIV (PLHIV). The efforts will focus on strengthening integration and linkage of services across disease programmes within the health sector. Lessons learnt during the COVID-19 disruption of health services and the subsequent recovery should help to rebuild the national HIV and AIDS response in emergencies. This new Framework also demonstrates Government of Malawi’s strong commitment towards a multi-sectoral HIV and AIDS response, led and coordinated by the National AIDS Commission (NAC), with renewed participation of all partners and stakeholders. Consequently, the HIV Prevention Strategy should be used by all stakeholders, in line with the revised NSP, as a reference for planning and implementing HIV and AIDS programmes at all levels.
Malawi National Strategic Plan for HIV and AIDS 2023-2027
(National AIDS Commission, 2024-01-18) National AIDS Commission
The Revised Malawi National Strategic Plan (NSP) for HIV and AIDS 2023–2027 is the guiding document for the multi-sectoral response to the HIV and AIDS in Malawi. It extends and replaces the NSP 2020-2025, capitalising on recent local and international developments in policies and strategies on HIV and AIDS. It draws lessons learned from the first 2 years of program implementation, including implications of internal and external shocks such as the COVID-19 pandemic, other disease outbreaks, natural disasters, and global economic crisis. The revised strategy builds on remarkable achievements registered by Malawi by reaching 96:95:94 of the 95:95:95 Fast-Track targets ahead of schedule. It also endeavours to address shortcomings that prevent the country from drastically reducing new HIV infections and AIDS-related deaths. The strategy articulates Malawi’s renewed effort to accelerate the pace towards meeting the goal of eliminating AIDS as a public health threat by 2030. The vision of the revised strategy remains a healthy and prosperous nation free from the burden of HIV and AIDS. The revised NSP outlines the mission, objectives, strategic interventions, implementation arrangements and resources requirements over the 2023-2027 period to realise this long-term vision. The key targets by 2027 are to reduce the annual number of HIV infections from 16,400 in 2022 to 7,400 and AIDS related deaths from 12,100 in 2022 to 7,700 and to achieve virtual elimination of mother-to-child transmission of HIV (<5%). The strategy is aligned to various global frameworks such as the Sustainable Development Goals, the UNAIDS Fast Track Strategy and the Global AIDS Strategy 2021-2026, the Global AIDS Coalition 2025 Roadmap, the Global Fund Strategy 2023-2028 and PEPFAR’s Five-year Strategy: Fulfilling America’s Promise to End the HIV/AIDS Pandemic by 2030. The strategy has been aligned with local frameworks such as the Constitution of the Republic of Malawi; the Malawi 2063 (MW 2063); the 2018 HIV and AIDS (Prevention and Management) Act; the National HIV and AIDS Policy (2022); the Health Sector Strategic Plan 2023-2030; the National Health Financing Strategy 2023-2030; and other key health and sectoral strategies. The revised NSP is in sync with the Malawi 2063 and resultantly the Malawi 2063 first 10-year implementation plan (MIP-1). Specific HIV-related indicators that focus on reducing HIV prevalence, that are tracked through Health and Nutrition which falls under enabler 5: Human Capital Development of the MIP-1, are among the paramount indicators of the response. The revised NSP also recognises the ten Sustainable Development Goals (SDGs) that are key for ending the HIV epidemic, namely No Poverty; Zero Hunger; Good Health and Well-Being; Quality Education; Gender Equality; Decent Work and Economic Growth; Reduced Inequality; Sustainable Cities and Communities; Peace, Justice, and Strong Institutions; and Partnerships for the Goals. Thus, strategies outlined in the revised NSP will not only be key to achieving the HIV-related targets in the next five years, but also put Malawi on the path to reach SDGs targets. It is envisaged that all sectors that contribute to SDGs will play designated roles towards creating an environment not only for eliminating AIDS as a public health threat but also for positively transforming the socioeconomic wellbeing of Malawians. For this reason, the revised NSP emphasises the need for a multisectoral response and highlights the contributions needed from each sector to achieve broader social goals. Success of the revised NSP will depend on strong leadership and commitment from all relevant sectors and a resilient and sustainable health system.