title: Integration of HIV in child survival platforms: a novel programmatic pathway towards the 90-90-90 targets.
abstract: BACKGROUND
  Integration of HIV into child survival platforms is an evolving territory with multiple connotations. Most literature on integration of HIV into other health services focuses on adults; however promising practices for children are emerging. These include the Double Dividend (DD) framework, a new programming approach with dual goal of improving paediatric HIV care and child survival. In this commentary, the authors discuss why integrating HIV testing, treatment and care into child survival platforms is important, as well as its potential to advance progress towards global targets that call for, by 2020, 90% of children living with HIV to know their status, 90% of those diagnosed to be on treatment and 90% of those on treatment to be virally suppressed (90-90-90).
  
  
  CONCLUSIONS
  Integration is critical in improving health outcomes and efficiency gains. In children, integration of HIV in programmes such as immunization and nutrition has been associated with an increased uptake of HIV infant testing. Integration is increasingly recognized as a case-finding strategy for children missed from prevention of mother-to-child transmission programmes and as a platform for diffusing emerging technologies such as point-of-care diagnostics. These support progress towards the 90-90-90 targets by providing a pathway for early identification of HIV-infected children with co-morbidities, prompt initiation of treatment and improved survival. There are various promising practices that have demonstrated HIV outcomes; however, few have documented the benefits of integration on child survival interventions. The DD framework is well positioned to address the bidirectional impacts for both programmes.
  
  
  CONCLUSIONS
  Integration provides an important programmatic pathway for accelerated progress towards the 90-90-90 targets. Despite this encouraging information, there are still challenges to be addressed in order to maximize the benefits of integration.
authors.affiliation: Health Section, UNICEF, New York, NY, USA; dchamla@unicef.org.
authors.forename: Dick D
authors.initials: DD
authors.lastname: Chamla
authors.affiliation: HIV Department, World Health Organization, Geneva, Switzerland.
authors.forename: Shaffiq
authors.initials: S
authors.lastname: Essajee
authors.affiliation: Health Section, UNICEF, New York, NY, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Young
authors.affiliation: Global HIV Program, Management Sciences for Health, Arlington, VA, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Kellerman
authors.affiliation: MCH Department, Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, USA.
authors.forename: Ronnie
authors.initials: R
authors.lastname: Lovich
authors.affiliation: HIV Department, Clinton Health Access Initiative, New York, NY, USA.
authors.forename: Nandita
authors.initials: N
authors.lastname: Sugandhi
authors.affiliation: HIV Office, USAID, Washington, DC, USA.
authors.forename: Anouk
authors.initials: A
authors.lastname: Amzel
authors.affiliation: HIV Section, UNICEF, New York, NY, USA.
authors.forename: Chewe
authors.initials: C
authors.lastname: Luo
mesh_terms: D002648:Child; D002662:Child Health Services; D019033:Delivery of Health Care, Integrated; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D016019:Survival Analysis
keywords: HIV; PITC; child survival; double dividend; integration; maternal-child health