Phone: +855 23 219 274 or +855 23 224 971
Email: info@cenat.gov.kh
Language: 
Tuberculosis and HIV/AIDS have synergistic health impacts in terms of disease development and progression.
Therefore, collaborative TB and HIV/AIDS activities are a logical health systems response. However, the
establishment of these activities presents a challenge for countries that have strong vertical disease programs that
differ in their implementation philosophies. Here, we review the process by which TB/HIV collaboration was
established in Cambodia. A cycle of overlapping and mutually reinforcing initiatives – local research; piloted
implementation with multiple options; and several rounds of policy formulation guided by a cross-functional
Technical Working Group – was used to drive nationwide introduction of a full set of TB/HIV collaborative activities.
Senior Ministry of Health officials and partner organizations brought early attention to TB/HIV. Both national
programs implemented initial screening and testing interventions, even in the absence of a detailed, overarching
framework. The use of multiple options for HIV testing identified which programmatic options worked best, and
early implementation and pilots determined what unanswered questions required further research. Local conduct
of this research – on co-treatment timing and TB symptom screening – speeded adoption of the results into policy
guidance, and clarified the relative roles of the two programs. Roll-out is continuing, and results for a variety of key
indicators, including screening PLHIV for TB, and testing TB patients for HIV, are at 70-80% and climbing. This
experience in Cambodia illustrates the influence of health research on policy, and demonstrates that clear policy
guidance, the pursuit of incremental advances, and the use of different approaches to generate evidence can
overcome structural barriers to change and bring direct benefits to patients.
Document's year of publication: 2011-2015
Document type:
File:
| Attachment | Size |
|---|---|
 The multi-step process of building TB-HIV collaboration in Cambodia..pdf | 158.91 KB |
