Involving Community is Key to Integrating HIV & AIDS Programs with Other Health Services

Involving Community is Key to Integrating HIV & AIDS Programs with Other Health Services

Next month in Vienna, Austria, thousands of activists, community workers, donors, health leaders, and government officials will gather for the VVIII International AIDS Conference.  This year’s theme is Rights here, right now: a mandate on the importance of health as a human right for all.  While it is easy to talk about health as a human right, it is much more difficult to deliver to diverse communities in some of the poorest countries around the world. 

Last year when President Obama announced his Global Health Initiative (GHI), he spoke about meeting the health needs of the world by leveraging current resources and integrating programs for greater health impact. Integrating HIV & AIDS services with other health services such as reproductive health (including family planning), TB, malaria, or maternal and child health increases effectiveness and ultimately sustainability. 

This does not always mean integration of all HIV&AIDS programs with other programs is appropriate nor does it mean it’s the cheap way out.  As Ann Gavaghan, Chief of Staff, U.S. Office of Global AIDS Coordinator, put it two weeks ago at the Global Health Council conference, “we have to be careful to implement ‘smart integration’ to maximize the impact of our investments.”

MSH’s Community-Based Family Planning and HIV & AIDS Services Program in Malawi exemplifies our commitment to “smart integration.”  Through our project over 1,000 community-based distribution agents have been trained in integrated HIV and family planning/reproductive health services.  As a result of this training, nearly 700,000 people have received HIV and family planning messages in their communities, thereby enabling rural and hard-to-reach populations to access high quality integrated services closer to home. Total couple years of protection increased by 12,000 and between September 2008 and September 2009 the number of people who know their HIV status exceeded 67,000.

HIV integration is not a magic bullet and it is just one characteristic of MSH’s projects aimed at reversing the AIDS epidemic.  We design and implement highly effective programs that prevent the spread of HIV&AIDS, extend the lives of those currently infected with HIV, and mitigate the impact of HIV on those infected and affected.

While approaching integration from a systems angle is essential for cost-effectiveness, as a family physician, I also see integration from the perspective of the health needs of patients and their families.  What is a person with HIV facing regarding other health issues and how can these be addressed?  In reality, health and health care starts and ends in the household, in which every aspect of health is integrated in the individual and their family.   

I look forward to discussing lessons learned and successful models of integration with colleagues, partners, and peers at the International AIDS Conference where we are hosting a satellite session, Smart Integration: Challenges and Successes in Expanding Access to HIV & AIDS and Other Services on Tuesday, July 20 from 6:30-8:30pm.