Countries are facing acute challenges and new opportunities in how HIV, viral hepatitis and sexually transmitted infections (STI) services are funded and delivered. In recent years and months, efforts to strengthen country ownership, integration and sustainability have accelerated as donor funding declines.
Many countries are increasingly adopting a primary-health care (PHC) approach to address HIV, viral hepatitis and STI epidemics as part of a broader holistic and people-centred approach to health.
A new policy brief Integrating HIV, viral hepatitis and sexually transmitted infections (STIs) with primary health care: learning from countries highlights progress and lessons learned from efforts to converge, link and integrate these services with PHC in several low- and middle-income countries.
The overall experiences from selected countries in this brief – Angola, Botswana, Brazil, Ethiopia, Indonesia, Kenya, Pakistan, Rwanda, Viet Nam, and Zambia – show varied challenges, approaches and outcomes aligned with the 4 strategic and 10 operational levers described in the WHO/UNICEF PHC Operational Framework.
Acting on only 1 or 2 levers limits impact and reach in the context of complex ecosystems. Countries that prioritized 4 or more areas at the same time – across both strategic and operational levels – achieved the most sustainable results. The integration of disease-focused responses and services with PHC has led to improved access to services, enhanced service delivery, stronger community engagement, improved health outcomes and sustainable financing.
The policy brief recommends strengthening coordination and governance through strong political leadership, securing sustainable funding, and adopting a health system–focused approach. It advocates for task sharing within the health workforce and emphasizes meaningful community engagement to build trust and ownership. Addressing stigma and discrimination is a key priority, alongside leveraging digital technologies to improve service delivery. Finally, it highlights the importance of engaging the private sector to support innovation and expand reach.