Advocating for Differentiated Service Delivery (DSD) as a pathway for improving client’s quality of life and health systems efficiencies.

In the quest to end the AIDS epidemic, the ambitious Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 goals are that by 2020, 90% of people living with HIV (PLHIV) will know their status, 90% of people who know their HIV-positive status can access treatment, and 90% of people on treatment have suppressed viral load. These goals, together with implementation of the World Health Organization (WHO) 2015 recommendation to “treat all HIV-positive individuals with antiretroviral therapy (ART)”, has meant that already overstretched health systems will have to re-examine how ART care is delivered as more and more patients are now on ART and need support. WHO has recommended a “differentiated care approach” to improve client's lives and improve health system efficiencies and outcomes. 

Differentiated care is a client-centred approach that simplifies and adapts HIV services across the cascade to reflect the preferences and expectations of various groups of people living with HIV (PLHIV) while reducing unnecessary burdens on the health system. By providing differentiated care, the health system can refocus resources to those most in need. Differentiated care hinges on the fact that reaching more and more people will require an approach that has the potential to reduce costs and increase efficiencies using already existing resources while delivering care “in ways that improve quality of care and life”. 
 
Activists, implementers and health care workers at various levels should have the knowledge, skills and tools to facilitate the sharing of information on DSD with clients at the facility and at community levels, so as to create demand for DSD from communities.
This is critical if ending AIDS epidemic is to be realised.