Malaria and HIV/AIDS service integration

20081027_poster_140.jpgToday is the 20th anniversary of World AIDS Day. This is a good time to think about two diseases that have received some of the largest disease-specific funding in history.  The question is whether program planners for these two diseases not only recognize the effect each disease has on the other in overlapping areas of endemicity, but whether they maximize efforts to achieve synergies in joint programming.

According to Unicef, “In Africa, the HIV pandemic has been superimposed on the longstanding malaria pandemic, where P. falciparum malaria is consistently one of the major causes of infant and child mortality. The high prevalence of both HIV and malaria infection in Africa means that even small interactions between the two could have substantial effects on populations.” Some key points include –

  • HIV infection increases the incidence and severity of clinical malaria
  • Acute malaria infection increases HIV viral load

Korenromp and colleagues conclude that “Across 41 countries in sub-Saharan Africa, the HIV-1 epidemic may have increased the incidence of clinical malaria by 1.3% (95% CI 0.6%–7.9%) and malaria deaths by 4.9% (95% CI 3.1%–17.1%) in 2004.”

WHO has offered guidance on health systems response to the interaction of two diseases as follows:

  • integrating services for prevention, treatment and care for malaria and HIV within the framework of maternal and child health services, is vital for reducing the burden of both diseases
  • establishing mechanisms for collaboration and joint programming at various levels
  • strengthening health systems and capacity for equitable service delivery, to address the needs of poorer ommunities
    that are most at risk of these diseases

Hopefully joint planning will receive greater emphasis today and in the future from the major partners who support efforts to fund and control both diseases including the Global Fund, Unicef, WHO, The Clinton Foundation and the US Government (PEPFAR and PMI).

PS – if you haven’t signed the HIV-Malaria petition yet, today would be a good day to do so - to sign the petition click: http://www.malariafreefuture.org/HIVMalariaPetition.php

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