Our car has absolutely no business driving this rocky (small boulders, really) dirt/mud road—loaded down with four passengers, no less. A sagging bridge up ahead taunts us to attempt the crossing. But we make it across in order to reach the Palabana district rural health center, surrounded by fields of corn and pumpkins, with a few tethered goats thrown in for good measure. A mere 45 kilometers from downtown Lusaka, we could be in far off Western Province in this beautiful rural landscape.

We arrive at the center and are led to a circle of benches under the generous shade of the large acacia tree. We’re meeting with assembled village leaders and health workers to discuss the loss of the five-year sexual and reproductive health (SRH) project that ended in 2006.

“Unplanned pregnancy is feared more than HIV/AIDS among young people,” comments Nthazie Nalungwe, a striking young woman leader within Youth Vision Zambia, a sexual and reproductive health and rights (SRHR) advocacy group here in Lusaka. This comment is reflected among many young Zambian advocates, peer educators and health workers we’ve talked with, including those with organizations promoting abstinence-only. Perhaps it’s a good thing that condoms seem far more plentiful than other contraceptives in Zambia: dual protection by default.

The rainy season is coming to an end here in Zambia and the early morning sun floods the car as we pull through the front gate of Professor Nkandu Luo’s house in Lusaka to join her for breakfast. Luo is the former (and outspoken) Minister of Health who now leads two Zambian nongovernmental organizations (NGOs) tackling HIV/AIDS and women – the Society of Woman Against AIDS in Zambia (SWAAZ) and Tasintha, the only local organization focused on helping women leave commercial sex work. It is a survival strategy for many women in countries like Zambia with weak economies and high unemployment.

"Reproductive health has been left behind. We can’t fight HIV/AIDS unless we center it within sexual and reproductive health. The majority of those affected by and living with HIV/AIDS are women, especially young women in Zambia,” she thunders. Zambia’s draft reproductive health policy—first proposed ten years ago by Luo during her tenure leading the Ministry—remains untouched. It was never finalized nor implemented by her successors.