Bending the curve: The impact of integrating mental health services on HIV and TB outcomes
By Sarah Kline, CEO and Co-Founder of UnitedGMH
We are at a pivotal moment in the fight against HIV and TB. As the world gears up for a final push towards its goal of ending the pandemics by 2030, strengthening health systems and protecting the world’s most vulnerable has never been more important.
This week global leaders are gathering virtually at the UN High Level Meeting on AIDS to consider what should guide the future direction of the HIV/AIDS response. With brand new research providing fresh evidence that integrating mental health into HIV and TB programmes (closely associated diseases) would significantly accelerate progress towards the 2030 Sustainable Development Goals concerning these diseases, the way forward is clear. Mental health needs to be immediately placed at the centre of the global HIV and TB response, through full integration and adequate funding.
Our latest research
To mark the first day of the High Level Meeting we are launching groundbreaking research at our side event in collaboration with Frontline AIDS - research commissioned by United for Global Mental Health, supported by the Elton John AIDS Foundation, and conducted by Dr José Manuel Roche.
It has long been established that HIV, TB and mental and substance-use disorders are inextricably linked. Poor mental health is a risk factor for HIV and TB infection and, once infected, having HIV and/or TB is a huge risk factor for developing mental disorders. We know that people with HIV experience higher rates of depression, and those with mental health illness, such as depression, anxiety, and substance use disorders, are less likely to seek testing and follow guidance in response to their result.
With our latest research we can now confirm a longstanding suspicion - that integrating basic mental health and psychosocial services into HIV and TB programmes will not only help millions of vulnerable people, but will end these co-epidemics at a faster rate, and in a cost-effective way.
In fact, integrating mental health into HIV programmes could see almost 1 million people avoid contracting the illness - the same number of infections that is currently predicted for the year 2026. The benefits outweigh the investment required; while integration may not increase the cost of treatment of integrating mental health and psychosocial support services into existing programmes, speeding up the reduction of HIV infections by 10-17%.
The potential impact is even stronger when it comes to integrating mental health support into TB strategies. As many as 14 million infections will be avoided - more than the total number of global TB infections in any given year, speeding up the rate of reduction by 13-20%. Again these benefits will outweigh the investment required.
As with all pandemics and disease eradication efforts, the final stages are often the hardest and most prolonged, requiring new thinking and approaches. With this new evidence it is now undeniable that placing mental health at the heart of the approach will be critical in the fight against HIV and TB.
So what next?
We are now faced with a choice - either to continue along the current trajectory, or to take decisive action and ensure mental health is fully integrated into the global response to fighting the pandemics. We know that the latter would deliver huge returns for society, transforming the lives of those infected and significantly boosting the effectiveness of prevention and treatment programmes.
That’s why donors and global institutions around the world, including The Global Fund to Fight AIDS, TB and Malaria, must install a holistic approach to care, viewing mental health as an integral part of their strategy, rather than a sub-sector of the health system or a mere “add on”. Governments also have a responsibility in this, and should ensure that mental health is included in the political declaration for the upcoming High Level Meeting next week and in their own HIV and TB programmes.
It is only by ensuring full integration of mental health into global response plans that we can reach the 2030 targets we have committed to achieving, with catalytic investment ensuring a strengthening of health systems at a time when it is needed most.