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In this episode of Going anti-Viral, Dr Michael Saag speaks with Dr Izukanji Sikazwe, the Chief Executive Officer for the Centre for Infectious Disease Research in Zambia (CIDRZ). Dr Sikazwe joins Dr Saag to provide an overview of her symposium presentation at the 2025 Conference on Retroviruses and Opportunistic Infections (CROI) entitled Innovations in HIV Service Delivery: Building a Path Forward with Those Left Behind. Dr Sikazwe discusses her career journey in treatment of HIV in Zambia and her path to CIDRZ. Dr Sikazwe and Dr Saag discuss the history of HIV and AIDS in Zambia and address the impact that PEPFAR had on the disease when it arrived in the country in 2004. They discuss how PEPFAR has operated in Zambia and provide a current overview of the sudden cancellation of USAID contracts on those receiving HIV care and treatment and other health services. Finally, they look ahead given the current disruptions on how Zambia and other countries can move forward to meet the needs of those in need of care. 0:00 – Introduction 1:41 – Dr Sikazwe reviews her path to CIDRZ 5:21 – History of HIV and AIDS in Zambia and discussion of stigma 7:53 – The impact of PEPFAR’s arrival in Zambia and Dr Sikazwe’s personal history with treatment during that time 13:37 – How PEPFAR works in Zambia 16:56 – Impact of recent decision by the US government to cancel USAID contracts 22:31 – Disruption to other health services that USAID has supported in Zambia 23:50 – Response from the government in Zambia 24:46 – Status of HIV in Zambia prior to cancellation of USAID contracts 25:50 – The best-case scenario for people living with HIV globally and closing remarks Resources: CROI 2025: https://www.croiconference.org/ Centre for Infectious Disease Research in Zambia (CIDRZ): https://www.cidrz.org/ PEPFAR: https://www.state.gov/pepfar/