Countries showcase benefits of scaling up HIV/AIDS services using WHO approach

WHO/Michael Jensen
Action in the field: health workers are participating in an IMAI training in Hoima, Uganda.

At a recent satellite meeting during the 14th International Conference on AIDS and STIs in Africa (ICASA) held in Abuja, Nigeria, more than 250 participants gathered to discuss issues that lie at the heart of the fight against HIV/AIDS -- shortage and inefficiency of human capacity available in developing countries to deliver HIV/AIDS prevention, care and treatment services.

The satellite meeting was organized by the WHO's team for IMAI (Integrated Management of Adult Illness). The IMAI is the approach that promotes training, monitoring and development of a comprehensive delivery of medical and social services for people living with HIV and AIDS, while building up and strengthening vital capacity to continue delivering such services in the health sector and communities.

For the implementation of IMAI in countries, WHO offers a set of operational tools that enables the decentralized delivery of ART, prevention and care with broader involvement of communities of people living with HIV/AIDS. In using IMAI tools, countries adapt the materials into their own social, cultural and health system contexts, with broad technical support provided by WHO throughout the process.

During the satellite titled "An operational package of HIV/AIDS treatment, prevention and care in the health sector", countries presented their own experiences in adapting and using IMAI for the scale up of HIV services.

Uganda has been a pioneer in the implementation of IMAI since 2003. As of end 2005, Uganda has successfully trained 1570 health care providers in the comprehensive management of HIV/AIDS and expanded the number of sites delivering ART treatment across the country. Dr Elisabeth Madraa, Programme Manager of the National HIV/AIDS Programme of Uganda stated that the country would not have been able to put 67 000 people on ARVs if full sensitization and mobilization of the community health workers had not been implemented as part of the IMAI approach.

For more information on Uganda's IMAI experience, please see the following presentation.

Senegal scaled up the number of sites offering HIV treatment from 6 to 32 between 2001 and 2005. About 4 000 people in the country are receiving ART -- more than 50% of those in need. Senegal faced the critical need to decentralize treatment from the capital city to rural provinces. Using IMAI packages, the country trained health care providers in 15 districts between May and October 2005 and plans to cover the remaining 38 districts by the end of 2006.

Senegal has also been instrumental in offering to conduct training activities in other developing countries, as a key mover of the "South to South" cooperation among countries adapting the IMAI approach.

For more information on Senegal's IMAI experience, please see the following presentation.

Lesotho first introduced IMAI in April 2005 and plans to roll-out training throughout the country by June 2006. The country, which has the third highest HIV prevalence in the world, has embarked on a grand initiative to offer HIV testing and counselling to its all citizens above the age of 12. The campaign would require a massive scale up in terms of availability of HIV prevention, treatment and care services in the country, and implementing IMAI can help achieve this.

For more information on Lesotho's IMAI experience, please see the following presentation.

WHO Regional Office for Africa has played an essential role in regional and country adaptations of IMAI. Sharing a regional perspective, Dr Georges Ki-Zerbo from the WHO Regional Office for Africa said that "Helping countries to facilitate universal access to prevention, care and treatment for HIV/AIDS is a core mission of WHO in its response to the epidemic, and IMAI enables this."

The IMAI approach has now been used in 27 countries of Africa, and its expansion to India, China and Viet Nam is underway.

For more information on WHO's capacity building activities on HIV/AIDS, please visit and

"We could not have done without IMAI."

- Dr Elisabeth Madraa, Programme Manager of the National HIV/AIDS Programme, Uganda

"IMAI came to our help when we were trying to find the way to bring HIV services from the capital to the villages."

- Prof. Papa Salif Sow, Director of the Department of Infectious Diseases of the Dakar University Teaching Hospital, Sénégal

"Universal offer of HIV testing and counselling and a full roll-out of IMAI can help save our country."

- Dr Limpho Maile, Director of the National HIV/AIDS Programme, Lesotho