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Domestic funding key to sustainability of HIV prevention and medication

The National HIV, AIDS and STI Control Programme (NACP) have come up with a strategic plan for 2017-2023 to be implemented within the framework of Bhutan’s 12th Five Year Plan.

Known as the National Strategic Plan III, it is designed to increase coverage of comprehensive package of HIV prevention services, reduce new HIV infections from 2010 to 2020 (leading to 90% reduction by 2030), achieve 90% Test and Treat targets by 2020 (leading to 95 % by 2030) and to retain 90% PLHIV on treatment, resulting in undetectable Viral Load.

It is also to eliminate new infections among children by 2020, enhance strategic information, build sustainable and cost effective systems for health, integration of HIV/STI services and achieve zero discrimination by 2020.

NSP III were developed to achieve 90-90-90 global targets for HIV response by 2020, and continue through the planning period, towards ending the HIV epidemic by 2030.

The NSP III is also designed with a objective to increase coverage of comprehensive package of HIV prevention services, to reduce new HIV infections from 2010 to 2020 (leading to 90% reduction by 2030), to achieve 90% Test and Treat targets by 2020 (leading to 95 % by 2030) and to retain 90% PLHIV on treatment, resulting in undetectable Viral Load.

It is also to eliminate new infections among children by 2020, to enhance strategic information, to build sustainable and cost effective systems for health, integration of HIV/STI services and to achieve zero discrimination by 2020.

NSP III states that, this seven-year strategy reflects the progress made in achieving a clearer understanding of the challenges posed by the epidemics and the increasing unity of purpose among all the stakeholders who are driven by a shared vision to attain the highest impact towards a long-term vision of ending the AIDS epidemic as public health threat in Bhutan.

However, in the NSP III, Bhutan commits to Fast Tracking the HIV and AIDS response through task sharing and multi-sector approach. “The first phase of the NSP III, during 2017-2020, aims to reach the 90-90-90 targets: 90% of key populations tested for HIV and knowing their results, 90% of people infected with HIV placed on ART, and 90% of these adhering to treatment resulting in suppressed viral load,” says the strategic plan.

In addition, Bhutan also commits to “Ending AIDS” by 2030 through achieving the 95-95-95 target: 95% of key populations tested for HIV and knowing their results, 95% of people infected with HIV placed on ART, and 95% of these adhering to treatment resulting in suppressed viral load.

NSP III will be reviewed during the midyear of its implementation (2020) for relevance and effectiveness.

The NSP III also emphasises adhering to global and regional principles for achieving the Sustainable Development Goals. It contains four strategic directions which includes prevention of HIV transmission through outreach and in-reach, universal access to HIV and STI testing and screening, comprehensive continuum of care for PLHIV and people with STI and TB/HIV co-infection and strategic information for evidence informed programming.

The present Global Fund grant of USD 5.7 million will expire by 2018 and support from other donors including UN systems is expected to become smaller as Bhutan transitions to a middle-income country. This makes domestic funding for health services the key to long-term sustainability.

“Increasing domestic financing is imperative for fast tracking and sustaining the response. Use of the Health Trust Fund mechanism for funding the response will be explored,”, the strategy states.

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