A new chapter is unfolding in the global response to the HIV/AIDS epidemic. While the last decade has seen an unprecedented worldwide emphasis on scaling up diseasespecific programs for HIV and other priority diseases, major donors are rapidly embracing a new paradigm that emphasizes
service integration and the “mainstreaming” of HIV into broader health systems and programs. In the U.S., the trend is evidenced by the Obama Administration’s emphasis on health systems strengthening over more “vertical” disease-specific programming, and on promoting greater ownership of health programming by country governments that receive external donor assistance to meet domestic health needs.
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