Table 1.

The three phases of the health sector response to HIV: key features and milestones

	Phase I (1991–2000)	Phase II (2001–2011)	Phase III (2012–2020)
HIV epidemic	Adult prevalence peaked at 1.7% in 1998 Most new infections from brothel sex work	Adult prevalence declined to 0.8% in 2011 Sex work shifted to entertainment establishments MSM/TG/PWID emerged	1350 new infections in 2012 - 50% partners and casual - 40% key populations - 10% MTCT
HIV prevention for key populations	100% condom use for brothel-based sex workers IEC for general population	Peer outreach to entertainment workers and other emerging key populations, with referral to health services	Sharpening response to key populations at higher risk
Testing and counselling	VCCT in main cities	Nationwide expansion of VCCT in all operational districts and 20% of health centres PITC in most health centres	Finger-prick HIV testing and counselling in all health centres and outreach settings Testing of partners of PLHIV and key populations
Care and treatment including PMTCT	Extensive home-based care PLHIV peer support groups and network emerged	ART scale-up Expanding PMTCT and TB/HIV	Maximizing retention throughout cascades including partner testing and TB/HIV Test and treat Elimination of MTCT
Strategic information	Sentinel surveillance	Electronic database for each service Continuous quality improvement	Client tracking across services Monitoring impact HIV drug resistance
Orientation of programme management	Vertical	Linkage	Integration

IEC=information, education, communication; MTCT=mother-to-child transmission; MSM=men who have sex with men; PITC=provider-initiated testing and counselling; PMTCT=prevention of mother-to-child transmission; PWID=people who inject drugs; VCCT=voluntary confidential counselling and testing; TG=transgender.