Is integration the answer for Africa?

Since the International Conference on Population and Development (ICPD) in 1994, much rhetoric and some action have been expended on the attempt to integrate family planning with services that manage sexually transmitted infections (STIs) and HIV/AIDS. For some regions in the developing world, integration may be both feasible and appropriate. In Sub-Saharan Africa, however, the effort to integrate services may not be successful and is subject to risks that should be considered carefully. Service programs in this area are severely challenged and fragile. Sub-Saharan Africa is the only major region in the world where the majority of countries have yet to show significant fertility declines and where the total fertility rate still has not decreased far below six lifetime births per woman.¹ It is also the region that is home to 70% of the people in the world who have HIV/AIDS;² indeed, half the world's total infected persons are among the 4% of the global population living in East and southern Africa.³.