Ladies and gentlemen, On behalf of my country, the Republic of Côte d’Ivoire, I want to tell you how very pleased I am to be part of this high-level meeting, within the framework of the 9th IAS Conference on HIV Science to discuss once again this infection as its morbidity and mortality rates still remain high globally, and especially in our countries in the South. However, the trend in the evolution of the epidemic, as well as the efforts made by governments on the one hand, and the international community on the other, give us hope that progress is possible towards achieving the goal set by UNAIDS of eradicating the virus by 2030, a goal we all fully support.

HIV infection - and this is possibly not emphasized enough - is also a chronic condition which requires daily patient management. This has resulted in changes in some practices such as health service delivery. Ever since the emergence of HIV infection, some remarkable achievements have been obtained. According to UNAIDS, in 2016, 19.5 million people living with HIV have received ART vs 7.7 in 2010. The number of AIDS related deaths have dropped 48% during the same period.

In Côte d’Ivoire, progress made in the fight against HIV and AIDS stems of course from scientific developments, for instance the availability of medications, but also programme-based interventions designed to tackle such challenges as setting up health service delivery and integrating HIV related service delivery into the global health system. And so, experiments and best practices which ensured this progress in the fight against HIV and AIDS could easily be replicated in the prevention and service delivery for other chronic diseases.

The provider-initiated HIV testing and counselling strategy which has helped raise the level of knowledge about HIV status in the population but, above all, has helped identify HIV positive persons, could prove very useful as we currently face another public health threat with hepatitis viruses. Active screening associated with immunization could help contain the progression of the virus quite efficiently. Incidentally, this strategy is implemented for Eliminating Mother-To-Child HIV Transmission (EMTCT) or in combining HIV and syphilis testing which helps us make headway towards eradicating congenital syphilis.  

The example of Differentiated Service Delivery for HIV care rolled out as part of “Test and Treat All” could inspire us to improve follow-up of patients living with non-communicable diseases who are often elderly as well as physically and financially vulnerable. These diseases constitute one of the major public health threats in developing countries as a result of urbanization, a more sedentary lifestyle and changed eating habits in the local populations.  

As it turns out, interventions aiming at prevention and improving the quality of life of People Living with HIV also include screening and health service delivery for non-communicable diseases. These strategies are and must be spread to the HIV negative population who can thus benefit from infrastructures set up as part of a public health approach.

 Thus, the service delivery model set up for HIV, based on a strategy aimed at treating as early as possible and as soon as the patient is able to receive treatment, can and must be applied to other infectious diseases with a view to avoiding missed opportunities and containing transmission.

In situations where access to lab facilities can amount to a luxury, the use of treatment kits, as in the case of sexually transmitted infection health service delivery as part of a syndromic approach, could also make for a valuable alternative to tackle high mortality in some geographic areas.   Laboratory facilities set up for virological follow-up of People Living with HIV should be used for diagnosis and follow-up of patients with viral hepatitis B and C. Training, acquired expertise and strengthening of laboratory capacities enables us to meet challenges posed by emerging diseases in human as well as animal health.

Viral and bacterial resistance are a matter of concern as regards service delivery for People Living with HIV. The World Health Organization’s latest statistics point to a rise of over 10% in first-line anti-retroviral treatment in countries with limited resources. Against this backdrop, the sentinel surveillance model for HIV and malaria as well as the response with new alternatives in the form of new molecules must be applied to other infectious diseases.

Ladies and gentlemen, distinguished delegates, I have only touched upon some tried and tested strategic approaches that have been implemented to tackle the HIV epidemic. There are many more and it is up to us to build on all of them and roll them out in the broadest field of global health for the well-being of our populations. Thank you.