Maintaining and developing health systems to sustain HAART

Abstract This chapter focuses on countries where the impact of HAART on health systems is likely to be most significant; the analysis targets countries with fragile health systems, high HIV prevalence, and generalized epidemics — the scenario in sub-Saharan Africa. Drawing on secondary data in the form of published studies, it considers assumptions about the potential impact of HAART on health systems in sub-Saharan Africa and contrasts them with lessons that are currently being learned through empirical research. It argues that the current exceptional and largely vertical approach to provision of HAART in sub-Saharan Africa is an appropriate response, provided it is accompanied by simultaneous efforts to ensure that the rise of HIV incidence is stemmed as quickly as possible.