Integrate health services to fast-track war on HIV

Kenya has won praise for its ‘90-90-90’ target feat—90 per cent of people living with HIV knowing their status; 90 per cent of people who know their status on treatment; and 90 per cent of people on treatment with suppressed viral loads.

While congratulating the President’s Emergency Plan for Aids Relief (PEPFAR) and other stakeholders in achieving the UNAIDS goals, US Ambassador to Kenya Eric Kneedler recently mentioned this as a great move towards curbing the epidemic.

Kenya now joins the world towards the next set of goals to end Aids by 2030—dubbed 95-95-95—reduced number of new infections among adults and zero discrimination. Now is a critical moment for the epidemic. Increased and integrated investment in the HIV/Aids response is essential to create a country where nobody has Aids.

Integrating packages of care for HIV/Aids, tuberculosis (TB) and malaria across the reproductive, maternal, newborn and child health (RMNCH) continuum of care saves lives, reduces stigma and is cost-effective.

Evidence indicates that this—in addition to the integration of services for reproductive health and HIV/Aids—can be key to substantial and lasting progress towards meeting the health-related SDG3.

Most HIV infections are sexually transmitted or associated with pregnancy, childbirth and breastfeeding. Malaria during pregnancy is linked to low birth weight and premature birth; so, interventions targeting women infected with malaria during and after childbirth can significantly reduce malaria-related maternal, neonatal and infant mortality.

World Vision International categorises TB, particularly among HIV+ women, as a leading cause of non-obstetric maternal mortality. And co-infected pregnant women are more likely than HIV-negative pregnant women to transmit TB to their babies.

Interconnectedness

The interconnectedness of maternal and newborn and child health means integrated RMNCH services can help to reduce transmission of HIV, TB and malaria, consequently increasing access to treatment and improving overall RMNCH outcomes.

The continuum of universal health coverage (UHC) creates an opportunity to deliver integration of RMNHCH, HIV, TB and malaria at key entry points—including primary- and secondary care, health facilities and community settings, as clearly outlined in the Kenya Community Health Strategy 2020- 2025. This will help in ensuring value for money and promote human rights for all.

Mr Fatinato is youth coordinator at Centre for the Study of Adolescence; [email protected]. Ms Nthiana is youth advocate at the Network for Adolescent and Youth of Africa (Naya Kenya); [email protected].