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Political Declaration Target 10 - HIV Integration
Strengthen HIV integration
The sustainability of responses to the HIV epidemic has become a major international priority. If HIV responses can be integrated into healthcare systems and development efforts, much more efficient progress might be made than in a disease-specific response – as demonstrated with the importance of integrating treatment for HIV and tuberculosis (TB), Target 5. Integrated approaches help to enhance the uptake of HIV services and improve the coordination of care.
90 percent of reporting countries have indicated that integration is a national priority. Many countries report having aligned HIV response with other disease-specific planning or have integrated the response into national health and development plans. 53 percent (56 of 105) have taken steps to integrate HIV and TB services. 70 percent have integrated HIV services within antenatal care and maternal health services to prevent mother-to-child transmission. Two thirds have integrated the HIV response with sexual and reproductive health services. 23 percent (27 of 115) have integrated with services for chronic non-communicable diseases, though the extent and depth of this varies. 55 percent have integrated with general outpatient care, and 32 percent incorporate antiretroviral treatment into this care.
These statistics are reasonably encouraging, but reveal that significant challenges remain to making the HIV response sustainable. Strategic integration of HIV services within health systems is integral to an effective and sustainable response.
What still needs to be done?
- Recognise the need for a diverse approach to a sustainable HIV response. Integration methods need to be adjusted according to the needs and priorities of specific countries, especially those who still have disciminatory laws and practices.
- Emphasise integration of HIV services within non-health sectors. These sectors include nutrition and feeding programmes (a lack of food security being linked to the inhibition of effective prevention and treatment), education, and cash transfers.
- Enhance strong national leadership in individual countries to help eliminate ‘parallel structures’ and make treatment systems more efficient.
- External funding should move from funding single diseases to funding integrated health services. This would involve investment in physical infrastructure, training, management approaches and integrated reporting structures.
- Improve data collection and monitoring systems, so that integrated delivery models can be accurately assessed.
- 70 percent (77 of 109) of reporting countries are on track to achieve their integration commitments.
- 94 countries have included integration commitments in national strategic plans.