 So yes, I'm presenting the gaps in the cascade of care in two high prevalence setting in Zimbabwe and Malawi. So HIV population-based survey enabled to measure HIV outcomes at community level to define and prioritize intervention in HIV program. MSF started the implementation of HIV activities in two settings of GUTU in Zimbabwe and N-Sanjain in 2011 using the monitoring approach by decentralizing the ART diagnosis and treatment from hospital to clinic. MSF took the operational decision of implementing this population-based survey in these two settings to give information on HIV outcome to estimate the impact of the monitoring approach after five years of implementation and to define plans and interventions. Also last year, national surveys were implementing in Zimbabwe and Malawi at national level, which gave us the opportunity to compare the findings of our surveys with the outcomes of the national survey. So briefly to show you where the two settings are located. So N-Sanjain is at the bottom of Malawi surrounded by Mozambique and GUTU at the middle of Zimbabwe. In terms of study objectives, so I'm presenting here the objective for the one we have the result in this presentation, but we had also other objectives. So the primary objective was to estimate the population viral load among the adult more or equal than 15 years old. We took as a definition of viral load suppression, all viral load the result, less than 1,000 copies per milliliter. As a secondary objective, it was to estimate the cascade of care among HIV positive more or equal than 15 years old, to estimate HIV prevalence among the more or equal than 15 years old and to estimate the ART coverage among HIV positive more or equal than 15 years old. So cross-sectional population survey we're implementing in GUTU and N-Sanjain district between September and December 2016 using a multi-stage cluster sampling. We recruited all individual age equal or more than 15 years old and eligible children less than five years old in GUTU district and N-Sanjain district living at the time of the survey. But here I will only present the result for the adult. In term of study procedures, so the team went to the household randomly selected and asked the concern of the head of the household for interview and they performed the household questionnaire. Through the household questionnaire, they could identify all eligible individuals and after receiving the consent, they performed the adult questionnaire. Then they had a pre-concelling session before having HIV test on spot. Then according to the result of the HIV test, for positive and discordant, they received a post-concelling session, then a questionnaire on HIV and ART. We also draw blood for additional testing for those participants to conduct viral load, genotyping, ART blood level, incidence. We also conducted CD4 in GUTU and for 10% of the participants that were positive, we conducted HIV confectionary test for quality control. So in term of participation and inclusion rate, so in GUTU, 2,400 households were completed and 5,440 individuals eligible and we had good inclusion rate with overall 89% of individuals included and tested. In NSANJ, we completed 2,440 households, 5,222 individuals were eligible and overall also good inclusion rate with 87.8% of individuals included and tested. In terms of socio-demographic characteristics, so in both settings, most of half of the participants were women, most of half participants were married, farmers, and living continuously in the district. The median age of the participants was 36 years in GUTU and 33 years in NSANJ. In terms of HIV prevalence, so for the MSF survey overall in GUTU, we had 13.6% of prevalence and 12.1% in NSANJ. We can see in both settings that prevalence among women was higher than prevalence among men. Also stratified by gender and age group, we can see that in both settings that the HIV prevalence curve is increasing most slowly for men than women. And for both settings also, we got a low prevalence among young adults. So now I'm going to show you the results in the comparison of the 1990 coverage between the surveys in GUTU and the national survey. And to do so, we restricted our result to the age of 15 to 64 years to match with the age group of the national survey. So as you know, UNS has recently set up the target of 1990. So the objective is that by 2020, 90% of people living with HIV will be diagnosed. So is what is representing in the first part of the diagram with the first 90 diagnosed. By 2020, 90% of diagnosed people will be enrolled on ART. So that we represented on the second part of the graph. And then by 2020, 90% of people in treatment will have fully suppressed viral load and what we're representing in the graph. MSF is in red and is not appearing here, but the national survey is in blue. So we can see that overall, we have a good result in the 1990 coverage. And we can see that there is a difference between good two-settings and the national level for the two first 90 coverage. And we didn't see a difference for the third one. Among women, again, we can see good results in good two-settings, also in national settings, but we can see also a difference between MSF survey and the national survey in the two first 90s, but no difference in the third 90. Among men, again, good results with a difference in the first 90, even though among men we can see that the diagnosed coverage was lower than women. We could identify the gaps in good two to show that young adult 15 to 24 years old were 71% to be diagnosed, and young men less than 30 years old were 58% to be diagnosed. So now will be the result of N-SANJ, again, same to show the comparison between N-SANJ sitting and the national survey in Malawi. So we can see overall that the results are good. For both survey, but we could not see a difference between the MSF survey and the national survey. It was exactly the same for women. No really difference for the first 90, second 90, and third 90. And for men, we see a difference compared to women with lower coverage among men, but no difference in terms of diagnosis on the RTI or viral suppression between the two survey in good two and the national survey. Here again, we identify the gaps among the adult diagnosed. So with 64.3% of young adult diagnosed and 42.3% of men less than 30 years old. So what we can say about this finding, so we could see that there is an edging HIV positive population and about 25% of all HIV positive were above the 50-year-old. We had very good results in the 1990 coverage outcomes in both setting, but we could highlight a gender and age group imbalance, specifically in the first 90 of diagnosed. There is specifically in good two, difference, significant difference between the good two survey and the national survey. And we could see, we can estimate that there was an impact of good two project in this setting. We use the same method as the national survey, so we are confident that the difference is real. We could see that in N. Sanjay, there was no difference in the 1990 coverage and in both setting that the third 90 was also similar between the MSF survey and the national survey. So based on these results is to see how to move forward in this program and to choose on a strategic operation in these settings. In terms of limitation, we have still very low test results in good two and third. And also during, on the questionnaire, the IRT was self-reported. Although the team when they came to the household, they asked to see, for people who reported to be an IRT, to see the health plan. In terms of strengths, it is a cross-sectional survey that allowed the representability of the population living in both settings. We had a high participation rate even among men and we could compare our results between our results of the survey with the national survey. So I wanted to thank all the study participants, the community also of both settings. All the team worked very hard on this survey and MSF for Zimbabwe and Malawi and all other partners. Thank you. Thank you very much, Nolwen. We have time for a few questions. Looking around the room, so we have one, two, three, four. Let's start with that end of the room and we will take the question and then the answer at the same time. Yes, go ahead. Hi. Can you hear me? Yeah, Nathan, WHO. So the second 90 measures the number of people on treatment and the third is the number on treatment who have a viral load suppressed. What that doesn't capture is mortality and loss to follow-up. So I think if you're asking the question what's the added value of MSF's program, it would be important to also compare those critical outcomes. Or am I wrong? Does the virological suppression include death and loss to follow-up? No. No, OK. Thank you. But oh, sorry, so the question was, do you have an idea? Do you have an idea of mortality to follow-up in the program? OK. Do I have words, all right? Do you have a sense of mortality and loss to follow-up in the MSF programs? I think so I don't, I... I'm sorry, I can actually answer to this question. I think you're towards the field team. Coffee break discussion, thank you. Next one. There's a question up here. Yes, please. Hi, I'm Bev Stringer, I work with MSF. Thanks for an interesting presentation. I see that you work closely with the ministries of health in both locations. Have you discussed with them your results, especially linked to your male participants and what further information you might gather with regards to that? So for this question I'm going to answer on behalf of the team because I'm not working in the... I think there was a presentation in both settings, yeah. Thank you. But again, I'm not part of the operational team so maybe people can answer to that better than me. But I think there was because it was the plan so I think it was presented recently. Thanks. Right at the back of the room, yes. Yes, thank you. Sorry if I missed it at the beginning, but what was the actual rationale for doing the survey? Like, was there any reason to mistrust the national survey data or...? No, no, no. Sorry. Because also then, like, your results were quite similar to the ones that were then becoming clear from the national survey and yes, the question remains, what is the implication for the MSF team? So, sorry if I missed that one. No, as mentioned, maybe I was not clear at the beginning. As mentioned, MSF is working in these two settings for five years now and it was also to evaluate the program. So, to see what's the impact of the program compared to the national level. So, is it a reason... How to orientate the program? Is it a reason to stay? Is it a reason to orientate, for instance, we could see gap among male or young persons. So, how to orientate the program in the... It was not at all to mistrust the national survey and actually could see as we could show in this presentation. For instance, in GUTU, we can see a difference between the setting in GUTU and the national and the country. So, we can estimate that there is a real impact of this program of MSF in this area.