• Research Review
• Journal Summary

Title: Scaling up chronic care systems: Leveraging HIV programs to support non-communicable disease services

Authors: M Rabkin, S Nishtar

Reference: Journal of Acquired Immune Deficiency Syndrome 2011; 57:S87-S90 (open access) http://bit.ly/oeUKeZ

Summary by: Jocelyn Sterling, ProCor

Summary: A recent article from the Journal of Acquired Immune Deficiency Syndrome discusses the possibility of using current HIV programs to support NCD services.

The article argues that due to the availability of treatment, HIV has turned into a chronic condition. With so much funding and attention given to HIV, programs for HIV have developed the systems, tools, and approaches needed to support chronic conditions. On the other hand, very few low- and middle-income countries have national NCD programs, and large-scale NCD prevention, care, and treatment services are rare. Most of the time, resource-poor countries are unable to provide any sort of continual care services and only provide episodic care for immediate problems.

While HIV and NCDs are traditionally thought of as two very different health problems, some of the systems, tools, and approaches of long-term HIV programs could work for NCDs as well. Rather than start all new programs with an NCD focus, it may be wise to start NCD programs by adapting locally owned and validated approaches originally developed for HIV prevention, care, and treatment services. Through the implementation of many HIV programs over the last 10 years, lessons can be learned on how to successfully reach millions of people through new programs for NCDs. Resources - including strategies, systems, and tools - developed for HIV programs can also be adapted to support programs for NCDs.

The partnerships and visibility NCD has garnered over recent years could help increase advocates' ability to argue for more support. However, two strategic options remain: promote NCD-specific initiatives separate from programs targeted towards HIV, or push for NCD services to be included in HIV and primary health care programs.

Using HIV programs' experience and resources is a worthy option for increasing NCD initiatives. Whether it be integrating services for all chronic diseases - both NCD and HIV - or having separate services but drawing upon similar systems, leveraging HIV programs to support NCD services is an important option.