The following WHO resources are available to support the integration of HIV, diabetes, hypertension and mental health care:

• integration of noncommunicable diseases into HIV service packages (51);
• integrating the prevention and control of noncommunicable diseases in HIV, TB and sexual and reproductive health programmes (52);
• integration of mental health and HIV interventions: key considerations (53); and
• WHO’s Mental Health Gap Action Programme (mhGAP) operations manual (54). The decision to integrate diabetes and hypertension care into existing HIV programmes or to establish separate chronic disease clinics should be guided by factors such as the relative prevalence of conditions, contextual considerations, human resources and the capacity of current services. An international multi-stakeholder Delphi consensus study identified five essential items for effective integrated care for chronic conditions (55):
• improved data collection and surveillance of diabetes and hypertension among people living with HIV;
• strengthened drug procurement systems;
• availability of equipment and access to diagnostics;
• health education; and
• enhanced continuity of care. The chronic disease clinic model may offer a more effective and sustainable alternative to vertical programmes. It is important that all users of care services have access to care and treatment for diabetes, hypertension and mental health care regardless of their HIV status. A differentiated service delivery approach should be applied to determine who provides services, what services are provided, where they are provided and when they are provided.
• Who provides the services: assessment of the need and opportunity for task-sharing to non-physician healthcare workers should also be considered, including supervision and support across diseases. WHO hypertension guidance strongly supports task sharing to trained non-physician health-care workers and generally supports the integration of noncommunicable disease care into primary care (56). mhGAP also strongly supports the provision of mental health care at primary care and through trained non-physician clinicians (57).
• What services are provided: managing noncommunicable diseases and mental health conditions includes screening, detecting, treatment and providing access to palliative and rehabilitation services care for people in need. WHO clinical guidelines for managing diabetes, hypertension and mental health conditions are available (56, 58–59).
• Where are services provided: integrated services may be decentralized to primary care and the community. Opportunities for out-of-facility services should be considered, especially for medication refill provision for both ART and managing noncommunicable diseases. Integrated service delivery should also be considered in prisons and other places of detention.
• When are services provided: services for people with diabetes and hypertension may also be differentiated based on whether the client is established on treatment. Clinical visits for all conditions may be aligned and reduced to every 3–6 months among established clients (56), and multimonth dispensing should be the goal as for ART (60).