HIV and noncommunicable diseases: a case for health system building

Many low- and middle-income countries face a double burden of disease from infectious diseases such as HIV/AIDS and noncommunicable diseases (NCDs) such as diabetes, stroke and cancers. The health systems in such countries are weak and are severely challenged by the weight of a double burden of disease. The aim of this review is to examine current calls for a coordinated global response to HIV and NCDs and make a case for health system building in resource-constrained settings.

The main argument in favour of a coordinated approach is that HIV and NCDs share many similarities that make them ideal candidates for a coordinated approach. Therefore, there is no need to reinvent the wheel, as experiences with HIV programmes can be leveraged to NCD programmes, and vice versa. Critics, however, worry that coordinated approaches could among other things adversely affect the gains of HIV programmes.

Going forward, the overall benefit of a coordinated approach will be that health systems could be strengthened in a sustainable manner. However, such approaches must carefully weigh the benefits against risks to existing structures and must consider all the relevant stakeholders in their implementation.