27 May 2020 – Health systems are being strained worldwide by the rapidly increasing demands generated by the COVID-19 pandemic. An analysis of past crises indicates that mortality from vaccine-preventable and treatable conditions increases dramatically when health systems are overwhelmed by an outbreak. In order to avoid a system collapse, countries are expected to balance their efforts between responding to the outbreak and engaging in coordination and strategic planning to deliver essential health services through simplified mechanisms.

As a prerequisite for success, WHO recommends transparency, frequent communication and engagement with the public, ensuring protection and access to services for key and vulnerable populations, and high degrees of cooperation. The continuation of essential service delivery depends on:

• establishing a simplified coordination mechanism
• identifying context-relevant essential services
• optimizing service delivery settings and platforms
• establishing effective patient flow at all levels
• rapidly redistributing the health workforce capacity
• identifying mechanisms to maintain availability of essential medications, equipment and supplies. 

The national AIDS programme in Lebanon, in coordination with the WHO Regional Office and country office, as well as key stakeholders, such as donors and nongovernmental organization partners have intensified their efforts to continue serving key and at-risk populations based on the operational WHO guidance for maintaining essential health services during the COVID-19 outbreak. The following actions were undertaken:

• Establishing a coordination body with regular virtual WebEx meetings.
• Identifying an essential list of sexual health services, including condom distribution, HIV rapid testing, and the delivery of life-saving ART and PEP medication.
• Maintaining availability of essential medications and supplies through procurement and forecasting of stock-outs.
• Developing and communicating IEC material describing safe and unsafe sexual practices in the context of COVID-19.
• Establishing mechanisms of service delivery centred around avoiding risk of exposure and contamination with COVID-19.
• Redistributing the health workforce capacity to accommodate health needs and avoid contamination.
• Setting up IPC measures at premises of nongovernmental organizations through distribution of PPEs.
• Ensuring patient flow according to a working hours schedule and proper referral of potential HIV cases needing confirmation.
• Distributing life-saving medication to people living or at high risk of HIV.
• Providing 24/7 hotline services for emergencies and remote counselling.