HIV/AIDS Program Sustainability in Health Systems
Summary
Ensuring the sustainability of HIV/AIDS programmes within health systems is essential to preserving public health gains achieved over decades of global effort. Sustainability encompasses secure financing, robust governance, effective workforce development, resilient supply chains and integration of HIV services into broader health infrastructure. As donors gradually transition responsibilities to national authorities, countries must cultivate domestic revenue streams, devise clear transition roadmaps and strengthen institutional capacities. Governance frameworks that promote accountability and stakeholder engagement—particularly with civil society and affected communities—are vital for maintaining service delivery continuity. Technological innovations, from decentralised testing to digital adherence support, further bolster resilience, yet demand consistent investment and managerial oversight. Ultimately, sustainable HIV/AIDS responses require harmonisation of vertical interventions with primary healthcare objectives, ensuring that lessons from HIV financing and procurement catalyse broader health system strengthening and universal health coverage goals.
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HIV/AIDS Program Sustainability in Health Systems publication trend
The graph below shows the total number of articles in hiv/aids program sustainability in health systems across all publications each year (not limited to Nature Index journals).
Technical terms
Donor transition: The planned process of shifting programme ownership and financing from external agencies to national authorities and local stakeholders.
Opioid agonist therapy (OAT): A medical intervention using opioid-based medications to treat opioid dependence and reduce HIV risk among people who inject drugs.
Individual-based simulation model: A computational approach that simulates the behaviour and interactions of individuals to forecast epidemiological outcomes under varied scenarios.
Stochastic frontier analysis: A statistical method for estimating the maximum feasible level of an outcome, such as government spending, given observable economic and contextual constraints.
References
- The impact of the PEPFAR funding freeze on HIV deaths and infections: a mathematical modelling study of seven countries in sub-Saharan Africa. EClinicalMedicine (2025).
- Measuring sustainability of opioid agonist therapy programs in the context of transition from Global Fund support. Harm Reduction Journal (2024).
- Potential for additional government spending on HIV/AIDS in 137 low-income and middle-income countries: an economic modelling study. The Lancet HIV (2019).
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