In countries with high levels of poverty or instability and with poor health system management and governance, people are highly vulnerable to shocks associated with ill health, including major epidemics. An effective health system can help build their resilience by reducing exposure to infection and minimising the impact of sickness on livelihoods and economic development.
There is broad consensus on the key elements of such a health system: measures to protect public health, access to safe and effective basic health services, hospital back-up and a capacity to respond to major health shocks. The creation of such systems requires sustained efforts to strengthen state oversight of the health sector and to build effective partnerships for public health and service delivery. Managing the crisis response should include anticipating the need to build effective, trusted health systems that meet priority needs.
![Mubina [NAME CHANGED], 19, receives counselling and advice from a Dr. Irina Subotina, one of the first paediatrician who started treating children with HIV in Uzbekistan, at the Day Care Centre in the Research Institute of Virology of the Ministry of Health in Tashkent in Uzbekistan.
Mubina is from Tashkent. She is a 3rd year student of the medical vocational college. It is believed that she contracted HIV during a surgery. She discovered her HIV status when she was 16 years old. When being tested for HIV she did not received any counselling from medical professionals and had no idea about the infection, thus she was not able to absorb the news well. She refused to accept the diagnosis in the beginning. She became very isolated and was afraid to communicate with her friends and peers. Despite referral from doctors in AIDS Centre, Mubina refused to receive any services from the Day Care Centre. She simply did not wanted to communicate with staff of DCC either.
In November 2013 UNICEF invited Mubina to attend a training for adolescents with HIV who were aware of their HIV status. This was a turning point for Mubina . From that time her attitude toward the infection changed. She began to take ART regularly and started to attend psycho-support group in DCC. She also became an active member of the Peer-Support Group for Adolescents Living with HIV. Now she helps her peer to deal with stigma and discrimination.
Currently Mubina takes ART and has good blood test results. She also talks to other children and parents and encourages them about the importance of receiving ART, benefits treatment and how to live and grow with ART positively. Mubina is also a member of Y-PEER Network, where she talks to other young people about her experiences of living with HIV and problems with which adolescents living with HIV are currently facing in Uzbekistan. She also conducts information sessions in schools and colleges of Tashkent on prevention of HIV. UNICEF/UNI164691/Noorani](https://www.socialscienceinaction.org/wp-content/uploads/2017/01/UNI164691_Med-Res-1024x683.jpg)