Advancing functional and systemic integration of HIV prevention into public health systems

The global HIV response has delivered substantial progress, largely through vertical programmes that created parallel systems of financing, governance, and service delivery. Sustaining these gains requires embedding HIV prevention more fully within routine public health systems, particularly as external funding declines and health priorities evolve. This Series paper examines how the principal functions of HIV prevention-risk-based prioritisation, demand generation, quality service provision, and continuity of use-are grounded in long-standing public health principles and essential functions. By tracing these shared roots, we show that integration is not an abandonment of HIV prevention's distinctive achievements but an evolution towards more coherent and sustainable public health systems. Although integration moves HIV prevention beyond exceptionalist approaches, it should be understood as an advance that reinforces durability and equity rather than a compromise that dilutes past gains. Drawing on literature, expert consultations, and country experiences, we compare HIV prevention functions against frameworks, such as WHO's Essential Public Health Functions. This comparison highlights integration as a technically sound and conceptually coherent path and acknowledges the financial, political, and structural legacies of vertical programming. We conclude that system-level integration can sustain HIV outcomes and strengthen overall health system resilience.

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Publication Details

Journal
The Lancet Global Health
Published
2025-12-02
DOI
https://doi.org/10.1016/s2214-109x(25)00397-3
Citations
1
Primary Topic
HIV/AIDS Research and Interventions
Type
article
Field-Weighted Citation Impact
1.40

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article

Advancing functional and systemic integration of HIV prevention into public health systems

Chimika Phiri, Magreth Kagashe, Grace Kumwenda, Sara M. Allinder et al.
1 citations
The Lancet Global Health
HIV/AIDS Research and Interventions
1.40
article

Advancing functional and systemic integration of HIV prevention into public health systems

Chimika Phiri, Magreth Kagashe, Grace Kumwenda, Sara M. Allinder, Kenneth Ngure, Stephanie M. Topp, Raymond Yekeye, Gift Kawalazira, Joseph Murungu, Lilian Otiso, Carly A. Comins, S Konopka, Beatrice Matanje, Charles B. Holmes, Levie Gondwe, Virginia Thonyiwa, Agnes Langat, Betha O Igbinosun, Gisele Mujawamariya, Priscah Wawire
article en
1 citations

Abstract

The global HIV response has delivered substantial progress, largely through vertical programmes that created parallel systems of financing, governance, and service delivery. Sustaining these gains requires embedding HIV prevention more fully within routine public health systems, particularly as external funding declines and health priorities evolve. This Series paper examines how the principal functions of HIV prevention-risk-based prioritisation, demand generation, quality service provision, and continuity of use-are grounded in long-standing public health principles and essential functions. By tracing these shared roots, we show that integration is not an abandonment of HIV prevention's distinctive achievements but an evolution towards more coherent and sustainable public health systems. Although integration moves HIV prevention beyond exceptionalist approaches, it should be understood as an advance that reinforces durability and equity rather than a compromise that dilutes past gains. Drawing on literature, expert consultations, and country experiences, we compare HIV prevention functions against frameworks, such as WHO's Essential Public Health Functions. This comparison highlights integration as a technically sound and conceptually coherent path and acknowledges the financial, political, and structural legacies of vertical programming. We conclude that system-level integration can sustain HIV outcomes and strengthen overall health system resilience.

The Lancet Global HealthVol. 14(1)
Ministry of Health (ZM), Johns Hopkins University (US), Georgetown University (US), Jomo Kenyatta University of Agriculture and Technology (KE), Australian Institute of Tropical Health and Medicine (AU), Tanzania Commission for Science and Technology (TZ), Tanzania Commission for AIDS (TZ), Management Sciences for Health (US), Lilongwe University of Agriculture and Natural Resources (MW), National Aids Control Council (KE), President's Emergency Plan for AIDS Relief (US), University of Zimbabwe-University of California San Francisco (ZW), LVCT Health (KE), National AIDS Commission (MW), Ministry of Health (MW), Blantyre Institute for Community Ophthalmology (MW), Center for Innovation (US), Rwanda Biomedical Center (RW), National AIDS Council (ZW), James Cook University (AU)
Bill and Melinda Gates Foundation, Stanford University Center for Innovation in Global Health
Openalex Percentile: Top 14%
HIV/AIDS Research and Interventions
1.40
DOIOpen Access PDFOpenAlex
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