在不断变化的资金环境中维持优先的艾滋病毒、病毒性肝炎和性传播感染服务：业务指导

Pre-publication draftSustaining HIV, viralhepatitis and STI priorityservices in a changingfunding landscape:operational guidanceDepartment of Global HIV, Hepatitis and SexuallyTransmitted Infections ProgrammesWorld Health OrganizationUpdated June 2025 Pre-publication draftContentsAcknowledgementsExecutive summary1. Introduction and rationale2. Principles for setting priorities for health servicesEthical principlesProcedural principles3. Steps in setting priorities4. Governance and planning the priority-settingStrategic and operational enablers for priority-setting5. Setting priorities for services in the context of reduced resourcesPriority-setting: scoping, assessment and appraisalStepwise priority-setting approachTailored priority-setting considering population-specific needsFormulating and finalizing decisionsResults from a rapid global assessment exercise: indicative stepwisepriority-setting for HIV, viral hepatitis and STI services6. Systems, strategic and operational considerationsMaintaining quality of care during health systems transitionIntegrating service delivery within PHC person-centred models of careHealth workforce and systems resilienceMedicines and other health productsHealth financing considerations7. Communicating decisionsPublic communication of decisions and rationaleSupporting implementation and accountability8. Evaluating and sustaining progressSupport for data and monitoring systemsIncorporating Community-led Monitoring (CLM) and Quality of care MeasurementSetting priorities for indicators for action and monitoringDocumenting and sharing best practicesContinuing to work towards a sustainable response9. ConclusionsReferencesAnnex 1. Example of mapped baseline set of services and interventionsfor a country priority-setting exerciseAnnex 2. Scoring threshold tableAnnex 3. Fact sheet examples (A. Cost–effectiveness and B. Budget impact)Annex 4. Scoring sheet exampleAnnex 5. Baseline set of quality of care (QOC) indicators for a country priority-setting exerciseAnnex 6. Summary list: Priority-setting process planning and self-check questions iiiivvi15581011111516252830314142434750525656575858606164666768728182878890 Pre-publication draftivAcknowledgementsWHO gratefully acknowledges the manyindividuals and organizations who contributed todeveloping these guidelines.External contributors and peerreviewersYasmeen Akhtar (Nai Zindagi Trust, Pakistan),Florence Anam (Global Network of People Livingwith HIV – GNP+, Kenya), Nadia Badran (Societyfor Inclusion and Development in Communitiesand Care for All, Lebanon), Baker Bakashaba(AIDS Information Centre, Uganda), AdeleSchwartz Benzaken (AIDS Health Foundation– AHF Global Programme, Brazil), ByroneChingombe (Centre for Sexual Health andHIV/AIDS Research, Zimbabwe), Tom Ellman(Médecins Sans Frontières, South Africa), JosephFokam (Comité National de Lutte contre leSida, Cameroon), Anna Grimsrud (InternationalAids Society, South Africa), Ibtissam Khoudri(Ministry of Health, Morocco), Alvin Marcello(Asian Health Informatics Network, Philippines),Getrude Ncube (Ministry of Health and ChildCare, Zimbabwe), Francis Ndowa (Skin & GUMedicine Clinic, Zimbabwe), Clara Nyapokoto(Ministry of Health, Eswatini National AIDSProgramme), Nkechi Okoro (Network of PeopleLiving with HIV and AIDS in Nigeria), Leora Pillay(Frontline AIDS, United Kingdom), Jeremy Ross(TREAT Asia/amfAR, the Foundation for AIDSResearch, Thailand), Suilanji Sivile (Ministryof Health, Zambia), Ketevan Stvilia (NationalCentre for Disease Control and Public Health,Georgia), Maureen Syowai (International Centerfor AIDS Care and Treatment Program, ColumbiaUniversity - ICAP, United States of America),Iris Semini ( Joint United Nations Programmeon HIV/AIDS – UNAIDS, Switzerland), BeatrizThome (Global Fund to Fight AIDS, Tuberculosisand Malaria, Switzerland) and François Venter(University of the Witwatersrand, South Africa).The ICAP CQUIN Network contributed to thedrafting of the quality of care section.WHO Ethics and GovernanceSteering Group contributorsMaxwell J. Smith (Western University, Canada)drafted the Principles for setting priorities forhealth servicesnsection with input and review fromAnant Bhan (Yenepoya University, India), Voo TeckChuan (SingHealth, Singapore), Ezekiel J. Emanuel(University of Pennsylvania, United States ofAmerica), Sharon Kaur (Universiti Malaya, Malaysia),Keymanthri Moodley (Stellenbosch University,South Africa), Owen Schaefer (National Universityof Singapore), Ehsan Shamsi (Monash University,Australia) and Ross Upshur (University of Toronto,Canada). Ross Upshur co-chaired and presented atthe expert group consultation meetings.None of the individuals who supported thisguidance declared any significant conflict ofinterest relevant to the subject at hand.WHO staff and consultantsOverall coordinationThis publication development process wascoordinated by Clarice Pinto with guidance fromNathan Ford and under the leadership of MegDoherty, Director, Department of Global