Integrative Approach - The Way Forward
On September 19th, 2017 a new Joint Action on integrating prevention, testing and linkage to care strategies across HIV, viral hepatitis, TB and STIs in Europe (INTEGRATE) was launched in Brussels.
Throughout the day it was outlined that civil society plays a key role in reaching out to key populations at all stages, in prevention, testing and counselling, linkage to care and retention in care. And this does not only account for HIV but as much for Hepatitis and TB. Communities play an essential role in ending AIDS and TB and the elimination of viral hepatitis.
The so called integrated approach, which is responding not only to HIV but also to hepatitis and TB as mono infections should help to overcome thinking and acting in silos what the case is in most health systems. However, when it comes to prevention and harm reduction this is not new, as the most vulnerable persons were always at risk of not only one infectious disease and prevention conceptions have been addressing not only HIV. In this sense, many community settings are working on an integrated approach. In that sense the new Joint Action Integrate is a logical next step. It is much more important to get evidence and implement on a greater scale and make the results accessible to all countries and communities.
While the crucial role of civil society was acknowledged, it is still the most fragile partner in the holistic response to the epidemics. We see that in transition countries where community services are the first who cannot maintain their services when the Global Fund is leaving. That concerns harm reduction services as much as outreach and other prevention services among MSM and other communities. And worse, as soon as an organization is not receiving funding anymore, it disappears and it is an even bigger challenge to build them up again when funding is available again. In this sense, sustainability, if taken seriously, also means sustainable funding for community based organisations, otherwise the global targets will not be met.