MIN/Sp/AU/CAMH3/6 HIV/AIDS Page 7 Access to HIV interventions first and foremost requires availability of clear policies to guide which approaches to take and how to deliver the services. All countries are usually expected to have adequate policy document, as well as appropriate guidelines, for health workers to use during service delivery. Of the 35 countries that responded, 31 (90%), 28 (80%), and 21 (60%) reported having policy or guidelines on ART, PMTCT, and HTC—respectively. Only 17 countries—almost half—reported having such documents for all three interventions (Figure 3.1) 3.2.2 Setting National Targets for Universal Access There is no global target for Figure 3.2: % of countries that reported having national targets Universal Access in HIV for HTC, PMTCT, and ART, WHO African Region, 2007 prevention, care, and n=35 treatment. Each country, based on its resources and With PMTCT 77 targets work environment, is expected to set its own targets toward 69 With ART targets the Universal Access for HIV prevention, care and With HTC targets 69 treatment. As countries develop their national strategic All above targets 63 plans (NSPs), the expectation is for them to develop national targets for priority HIV interventions. Almost two-thirds (63%) of the countries reported setting national targets for HTC, PMTCT, and ART. Over three quarters (77%), have set national PMTCT targets, while 70% (24 countries) have set for HTC and ART (Figure 3.2). Meanwhile in Libya and Tunisia the target is 34% of infected men and women to receive ART. In other countries i.e. Egypt, Somalia and Sudan, the focus is on pregnant women and other infected women- the target ranges from 1.0% in Sudan to 7.3% in Egypt. 3.2.3 National Policy for Task Shifting and Free HIV Care and Treatment Services Human resource constraints represent the main health systems challenge facing most of the countries in the region to reach the global and national targets on Universal Access for HIV prevention, care, and treatment. In 2007, WHO, in collaboration with health development partners and national authorities, developed a plan to tackle the health workforce problems through a new initiative, which commonly known as “Treat Train Retain” or TTR. The TTR is based on three principles: I) Treat health workers by providing comprehensive care and treatment packages; II) Train, including task shifting to lower level health workers; III) Retain, through improving work environment, financial and non-financial incentives to motivate health workers to remain in country and