Public health approach to combating HIV/AIDS

Abstract

The HIV epidemic continues to take its toll in the SEA Region. Yet countries have demonstrated that implementing an effective response is feasible, both to halt and reverse epidemics and to provide services to those in need. To date, efforts to scale up HIV/AIDS programmes have involved a variety of different service delivery models, guidelines and tools for multiple HIV/AIDS interventions. Countries seeking to scale up HIV/AIDS health services to achieve universal access will benefit by adopting a service delivery model that brings together the best of these approaches and helps to compensate for the significant health systems challenges that many of them face. Accordingly, WHO promotes a public health approach to the delivery of health services for HIV/AIDS, drawing upon the successful experiences of other health programmes. A public health approach is one that is directed to address the health needs of a population, or the collective health status of the people, rather than just individuals. This paper discusses the four steps of the approach: • Define the problem and the risk factors; • Find out what works to control the disease; • Scale up effective interventions in a wide range of settings; and • Monitor/evaluate the impact and cost-effectiveness of these interventions. The key lessons for a public health approach to HIV include: • The health sector’s role is central in the overall national response to the epidemic; • A scaled-up integrated package of prevention, treatment, care and support services is necessary to halt and reverse the epidemic and mitigate its impact; • Implementing a scaled-up response to the HIV epidemic requires effective programme management, trained human resources and robust health systems. The points for discussion on how the public health approach to HIV can be strengthened further are proposed in this paper. The views and recommendations of the Meeting of the Advisory Committee (‎ACM)‎ on this agenda item will be submitted to the Sixty-first Session of the Regional Committee for its consideration.