One of the Theni District Positive regular social events which provide relaxation, comfort and support, India © Gideon Mendel for the Alliance A peer education leads a life skills session © Nell Freeman for the Alliance

Health and community systems strengthening

Aids AllianceAids Alliance

    A good health system delivers quality services to all 

Nurses measures out methadone at Ar Rahman mosque in Kuala Lumpur, Malaysia (c) International HIV/AIDS Alliance


If we are to reach global targets for universal access to HIV treatment, prevention, care and support, countries must have a strong health infrastructure which is able to reach all members of the population. A good health system delivers quality services to all people, when and where they need them.  

Unfortunately many countries have weak health systems which do not meet the needs of their citizens and many people do not access the services they are entitled to. To address this Alliance is dedicated to health systems strengthening (HSS) in the countries that we work in.

Traditionally HSS has focused on developing national public health systems. However, it has become evident that community systems are equally important. Civil society and communities play an essential role in mobilising people to access health systems and in providing care and support, particularly in the context of HIV. Community organisations and systems have a unique ability to interact with affected communities to understand and respond quickly to their HIV and broader health needs. In some contexts, community systems operate outside of mainstream health systems in order to reach people who are marginalised or stigmatised.

That is why we focus on community systems strengthening (CSS) as well as health systems strengthening.  In essence, community systems do not exist in isolation; they complement and are linked with formal health systems.

The Alliance approach

The Alliance takes an integrated approach to building high-impact and sustainable health and community systems through:

  • Contributing to global guidance and policy on health and community systems strengthening. The Alliance contributed to the Community Systems Strengthening Framework in 2009, and is currently working closely with the Global Fund to develop the Health and Community Systems Strengthening Guidance, which will maximise the impact of investments in health and community systems at the country level .
  • Documenting and demonstrating the results of community systems strengthening, including how community mobilisation increases uptake of PMTCT and home based care and STI services, how communities advocate for  maternal and child health at the community level, how to strengthen linkages between health and community systems and the impact of community systems strengthening on wider determinants of health.
  • Engaging actively global and national debates on HIV, health and community systems strengthening. Through our participation in the Action for Global Health network, we have been playing a key role in highlighting the synergies between HIV and the other health-related MDGs, particularly those related to maternal and child health, and the contribution that communities make in linking services and building stronger health systems. We will continue to advocate for better linkages between HIV and sexual and reproductive health and rights to respond more effectively to HIV and to individuals’ broader health needs.
  • Lobbying for innovative new mechanisms for financing HIV and health systems, including the Financial Transaction Tax.
  • Developing and advocating for innovative models of service delivery to address the shortage of health care workers in many countries. These both provide direct service provision and strengthen the referrals between community and health services.

Country programmes

  • We’re working in the Democratic Republic of the Congo to contribute to a lasting response to HIV by building the capacity of implementing NGOs and the government. Read more.
  • The Alliance’s Regional Technical Support Hub in the Caribbean contributed to a report undertaken by the AIDSTAR-Two Project. The report examined ways to make the health system in Jamaica better at reducing HIV among most-at-risk populations. Read more here.

Our partners

  • Action for Global Health
  • Global Fund to Fight AIDS, TB and Malaria