The international community’s health focus is shifting from achieving disease-specific targets towards aiming for universal health coverage. Integrating the global HIV/AIDS response into universal health coverage may be inevitable to secure its achievements in the long run, and for expanding these achievements beyond addressing a single disease. However, this integration comes at a time when international financial support for the global HIV/AIDS response is declining, while political support for universal health coverage is not translated into financial support. To assess the risks, challenges and opportunities of the integration of the global HIV/AIDS response into national universal health coverage plans, we carried out assessments in Indonesia, Kenya, Uganda and Ukraine, based on key informant interviews with civil society, policy-makers and development partners, as well as on a review of grey and academic literature. In the absence of international financial support, governments are turning towards national health insurance schemes to finance universal health coverage, making access to healthcare contingent on regular financial contributions. It is not clear how AIDS treatment will be fit in. While the global HIV/AIDS response accords special attention to exclusion due to sexual orientation and gender identity, sex work or drug use, efforts to achieve universal health coverage focus on exclusion due to poverty, gender and geographical inequalities. Policies aiming for universal health coverage try to include private healthcare providers in the health system, which could create a sustainable framework for civil society organisations providing HIV/AIDS-related services. While the global HIV/AIDS response insisted on the inclusion of civil society in decision-making policies, that is not (yet) the case for policies aiming for universal health coverage. While there are many obstacles to successful integration of the global HIV/AIDS response into universal health coverage policies, integration seems inevitable and is happening. Successful integration will require expanding the principle of ‘shared responsibility’ which emerged with the global HIV/AIDS response to universal health coverage, rather than relying solely on domestic efforts for universal health coverage. The preference for national health insurance as the best way to achieve universal health coverage should be reconsidered. An alliance between HIV/AIDS advocates and proponents of universal health coverage requires mutual condemnation of discrimination based on sexual orientation and gender identity, sex work or drug use, as well as addressing of exclusion based on poverty and other factors. The fulfilment of the promise to include civil society in decision-making processes about universal health coverage is long overdue.

中文翻译：

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将全球艾滋病毒/艾滋病应对措施纳入全民健康覆盖范围：可取，也许可能，但绝非易事

国际社会对健康的关注正从实现针对特定疾病的目标转变为旨在实现全民健康覆盖。从长远来看，将其艾滋病毒/艾滋病应对措施纳入全民健康覆盖范围可能是不可避免的，并且要扩大这些成就，而不仅仅是解决单一疾病。但是，这种整合是在国际社会对全球艾滋病毒/艾滋病应对工作的财政支持下降的时候，而对全民健康覆盖的政治支持并未转化为财政支持。为了评估将全球艾滋病毒/艾滋病应对措施纳入国家全民健康覆盖计划的风险，挑战和机遇，我们根据对民间社会的关键知情人士访谈，在印度尼西亚，肯尼亚，乌干达和乌克兰进行了评估，政策制定者和发展伙伴，以及对灰色和学术文献的评论。在没有国际金融支持的情况下，各国政府正在转向国家医疗保险计划来为全民医疗保险提供资金，使医疗服务的获得取决于定期的财政捐助。目前尚不清楚如何适应艾滋病治疗。尽管全球艾滋病毒/艾滋病应对措施特别关注由于性取向和性别认同，性工作或吸毒引起的排斥，但实现全民健康覆盖的努力侧重于贫困造成的排斥，性别和地理不平等。旨在实现全民健康覆盖的政策试图将私人医疗保健提供者纳入卫生系统，这可以为民间社会组织提供与艾滋病毒/艾滋病相关的服务创造一个可持续的框架。尽管全球对艾滋病毒/艾滋病的对策坚持要求将民间社会纳入决策政策，但针对全民健康覆盖的政策（目前）并非如此。尽管成功地将全球艾滋病毒/艾滋病应对措施纳入全民健康覆盖政策存在许多障碍，但整合似乎是不可避免的，并且正在发生。成功的融合将需要扩大“艾滋病毒/艾滋病对全球全民健康覆盖的应对措施”中出现的“分担责任”原则，而不是仅仅依靠国内的努力来实现全民健康覆盖。应该重新考虑将国民健康保险作为实现全民健康覆盖的最佳方法。艾滋病毒/艾滋病倡导者和全民健康支持者之间的联盟需要相互谴责基于性取向和性别认同，性工作或吸毒的歧视，以及解决基于贫困和其他因素的排斥。早就应该实现将民间社会纳入有关全民健康覆盖范围的决策过程的承诺。