In generalized epidemics with high HIV prevalence, the large numbers of people living with HIV mean that providing efficient and decentralized services is a key strategy in moving towards universal access. This requires a public health approach to scaling up services with emphasis on achieving broader coverage with key interventions; simple, standardized regimens and formularies; algorithmic clinical decision-making; effective supervision and patient monitoring; and integrated delivery of primary health care through health centres and in the community,
within a district health network.