22 July 2009

Shining Light on HIV and Health Systems Strengthening

The highlights of a two-day pre-conference meeting on Accelerating the Impact of HIV Programming on Health Systems Strengthening were presented in a satellite meeting on Tuesday, 21 July.

At the pre-conference meeting, 100 health systems and HIV researchers examined existing evidence on this crucial question and found that HIV scale-up has enhanced and strengthened key components of the health systems:

1. Health expenditures have increased.
2. The overall health workforce has become more innovative.
3. Human rights, social determinants and issues of equity are now at the forefront of primary health care.
4. There is global solidarity around the need for strengthened health systems.
5. Accountability and effectiveness of public health programmes and services has improved.

According to meeting participants, while scale-up of HIV treatment has enabled the building of emergency systems to put large numbers of people on antiretroviral therapy, HIV programmes must now evolve to allow for management of HIV as a chronic health condition.

Building integrated health services for broader health outcomes for people living with HIV is crucial. Countries that have strong maternal health services, for example, have been much more capable of managing and maintaining prevention of mother-to-child transmission programmes that support overall maternal health and child survival and not solely prevention of HIV transmission.

In the global downturn, it is also important to look more broadly at how HIV will drive broader social health insurance schemes. In public health programmes, antiretroviral therapy is usually free of charge, but people have to pay for transportation, nutrition, diagnostics and supplementary medicines. Financing strategies for HIV and health need to take this into account.

Vacancy rates in the global health workforce are high and research shows the need for further investment in supervision and management of health staff. Nurse-driven management of service programmes have shown significant successes in places like Lesotho and South Africa and need to be analyzed for replication in other settings.

Presentations from the report-back satellite session are available here.

[Update: Session webcast available.]

[Update: All presentations from the pre-conference meeting are available here.]

The Science Speaks blog also has a post on the satellite session: Prioritize Fighting AIDS...or Health System Strengthening...Or Both?

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