Defeating AIDS—advancing global health

Piot, Peter; Karim, Salim Safurdeen. Abdool; Hecht, Robert; Legido‐Quigley, Helena; Buse, Kent; Stover, John; Resch, Stephen; Ryckman, Theresa; Møgedal, Sigrun; Dybul, Mark; Goosby, Eric; Watts, Charlotte; Kilonzo, Nduku; McManus, Joanne; Sidibé, Michel

doi:10.1016/s0140-6736(15)60658-4

Cited by 232 publications

(210 citation statements)

References 108 publications

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“…Our report builds on numerous recent publications, including several African declarations and reports (panel 1 and table 3), and some Lancet Commissions. [10][11][12][13][14][15] The Commissioners represent various disciplines and sectors and include current and former ministers of health, heads of medical schools and research institutes, scientists, and individuals from NGOs and the business world. The Commission met three times-in Accra, Ghana, on May 7-8, 2013, in Addis Ababa, Ethiopia, on Jan 14-15, 2014, and in London, UK, on May 15, 2015.…”

Section: A Sobering Legacy a Promising Futurementioning

confidence: 99%

“…Ending HIV will require a vaccine . 12 While the overall downward trend in infectious diseases is encouraging, the gains to date are fragile and this is no time for complacency or scaling back programmes. If continued investment is not made in disease control there will be an upward surge, as seen for example with malaria in the 1960s, and with HIV in several communities on the continent.…”

Section: Infectious Diseasesmentioning

confidence: 99%

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The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa

et al. 2017

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Section: A Sobering Legacy a Promising Futurementioning

confidence: 99%

Section: Infectious Diseasesmentioning

confidence: 99%

The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa

et al. 2017

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“…It is estimated that over 700 million adults worldwide will be diagnosed with diabetes by 2025; increasingly and disproportionately in low and middle income countries, which lack affordable and available insulin and other essential medicines (NCD-RisC, 2016;WHO, 2016). HIV, despite decreases in overall new infections globally, remains a major threat among vulnerable groups worldwide and particularly in parts of Africa; nearly half of new HIV infections are people living in Nigeria, South Africa and Uganda, where HIV and AIDS is the number one cause of life-years lost (Collaborators, 2016;Piot, Abdool Karim, Hecht, & Legido-Quigley, 2015).…”

Section: Introductionmentioning

confidence: 99%

Integrating cardiovascular diseases, hypertension, and diabetes with HIV services: a systematic review

et al. 2017

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Non-communicable diseases (NCDs), including cardiovascular diseases (CVD), hypertension and diabetes together with HIV infection are among the major public health concerns worldwide. Health services for HIV and NCDs require health systems that provide for people's chronic care needs, which present an opportunity to coordinate efforts and create synergies between programmes to benefit people living with HIV and/or AIDS and NCDs. This review included studies that reported service integration for HIV and/or AIDS with coronary heart diseases, chronic CVD, cerebrovascular diseases (stroke), hypertension or diabetes. We searched multiple databases from inception until October 2015. Articles were screened independently by two reviewers and assessed for risk of bias. 11,057 records were identified with 7,616 after duplicate removal. After screening titles and abstracts, 14 papers addressing 17 distinct interventions met the inclusion criteria. We categorized integration models by diseases (HIV with diabetes, HIV with hypertension and diabetes, HIV with CVD and finally HIV with hypertension and CVD and diabetes). Models also looked at integration from micro (patient focused integration) to macro (system level integrations). Most reported integration of hypertension and diabetes with HIV and AIDS services and described multidisciplinary collaboration, shared protocols, and incorporating screening activities into community campaigns. Integration took place exclusively at the meso-level, with no micro-or macro-level integrations described. Most were descriptive studies, with one cohort study reporting evaluative outcomes. Several innovative initiatives were identified and studies showed that CVD and HIV service integration is feasible.Integration should build on existing protocols and use the community as a locus for advocacy and health services, while promoting multidisciplinary teams, including greater involvement of pharmacists. There is a need for robust and well-designed studies at all levels -particularly macrolevel studies, research looking at long-term outcomes of integration, and research in a more diverse range of countries.

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“…Indeed, a substantial component of this donor support was not integrated into the mainstream Ugandan health system [1]. During the ART scale-up phase, health facilities received a package of support comprising; a free supply of HIV commodities, health worker training in ART management, on-site support supervision and the strengthening of ART program reporting [10].…”

Section: Introductionmentioning

confidence: 99%

“…Against this background, the sustainability of the implementation of ART scale-up in SSA has come into critical focus [1,4,9–11]. The institutionalization or integration of interventions in the organizational routines of health service organizations is considered an important indicator of long-term program sustainability [12–16].…”

Section: Introductionmentioning

confidence: 99%

Assessing the level of institutionalization of donor-funded anti-retroviral therapy (ART) programs in health facilities in Uganda: implications for program sustainability

Zakumumpa

Kwiringira

Rujumba

et al. 2018

Global Health Action

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Background: In the context of declining international assistance for ART scale-up in Sub-Saharan Africa, the institutionalization of ART programs through integrating them in the organizational routines of health facilities is gaining importance as a program sustainability strategy. Objective: The aims of this study were; (i) to compare the level of institutionalization of ART programs in health facilities in Uganda and (ii) to explore reasons for variations in the degree of program institutionalization. Methods: In Phase One, we utilized Level of Institutionalization Scales developed by Goodman (1993) to measure the degree of institutionalization of ART interventions in 195 health facilities across Uganda. The 45-item questionnaire measured institutionalization based on four sub-systems (production, maintenance, supportive, managerial) theorized to make up an organization assessed against two levels of institutionalization; routines (lowest) niche saturation (highest). In Phase Two, four health facilities were purposively selected (2 with the highest and 2 with the lowest institutionalization scores) for a multiple case-study involving semi-structured interviews with ART clinic managers(n = 32), on-site observations and document review. Results: The two highest scoring health facilities had a longer HIV intervention implementation history of between 8 and 11 years. The highest scoring cases associated intervention institutionalization with sustained workforce trainings in ART management, the retention of ART-trained personnel and generating in-house ART manuals. The turnover of ART-proficient staff was identified as a barrier to intervention institutionalization in the lowest-ranked cases. Significant differences in organizational contexts were identified. The two highest-ranked health facilities were well-established, higher-tier hospitals while the lowest scoring health facilities were lower-level health facilities. Conclusions: The level of institutionalization of ART interventions appeared to be differentiated by level of care in the Ugandan health system. Interventions aimed at strengthening program institutionalization in lower-level health centers at the level of human resources for health could enhance ART scale-up sustainability.

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Defeating AIDS—advancing global health

Cited by 232 publications

References 108 publications

The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa

The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa

Integrating cardiovascular diseases, hypertension, and diabetes with HIV services: a systematic review

Assessing the level of institutionalization of donor-funded anti-retroviral therapy (ART) programs in health facilities in Uganda: implications for program sustainability

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