Building on what works: programme review identifies best practices and priority actions for Mongolia’s HIV and STI Response

The World Health Organization (WHO), in close collaboration with the Ministry of Health and the National Center for Communicable Diseases (NCCD), has concluded comprehensive programme reviews of Mongolia’s tuberculosis (TB) and HIV/sexually transmitted infections (HIV/STI) responses, conducted from 16 to 27 March 2026. The reviews were implemented in two phases: an online technical review followed by an in‑country mission with field visits to Ulaanbaatar, Darkhan‑Uul and Selenge provinces. The review examined key areas including epidemiological trends, governance and financing, service delivery models, laboratory and surveillance systems, prevention and treatment cascades and the integration of HIV/STI services within the broader health system.

Briefing meeting with consultants, the World Health Organization, Ministry of Health of Mongolia and the National Center for Communicable Diseases (NCCD). © WHO Mongolia 

The review team highlighted that Mongolia’s HIV and STI response has developed several strong practices that provide a solid platform for future progress. In Mongolia, HIV remains concentrated among key populations, and as such, the programme has increasingly aligned its strategies with evidence‑based, community‑centred approaches reflecting the country’s context and the global recommendations.

One of strengths of the response is the support of community‑led organizations in delivering HIV and STI prevention, testing and linkage to care for key populations, including men who have sex with men, transgender people, and female sex workers. Through trusted outreach, peer‑based service delivery, and community‑led monitoring, they have helped expand coverage, address stigma and discrimination and improve accountability and service quality.

The national programme has also demonstrated innovation in prevention. HIV self‑testing has been piloted through community outreach, enabling earlier diagnosis for individuals reluctant to attend health facilities. Virtual outreach through online platforms has further expanded reach, particularly among hidden populations. In parallel, pre‑exposure prophylaxis (PrEP) has been introduced for key populations, marking an important step toward more differentiated and client‑centred prevention services in line with WHO guidance.

Another notable achievement is the improved targeting of HIV testing. Efforts to refocus testing toward key populations have contributed to a timely identification of new HIV diagnoses in recent years. Importantly, most people are now diagnosed early, enabling timely initiation of antiretroviral therapy and reducing the risk of onward transmission. Once diagnosed, treatment outcomes are strong: antiretroviral therapy coverage among those diagnosed is high, viral suppression rates are excellent, and loss to follow‑up remains low. Integrated service delivery for HIV, STIs, tuberculosis and hepatitis further strengthens continuity of care and patient outcomes.

Integrating HIV and STI screening in antenatal care

Mongolia has also made impressive progress in preventing mother‑to‑child transmission of HIV, syphilis and hepatitis B. Antenatal care coverage is consistently high and routine screening for HIV and syphilis reaches nearly all pregnant women. Based on programme data, Mongolia is likely to have achieved elimination targets for mother‑to‑child transmission of HIV and syphilis.

Surveillance and monitoring systems provide another area of strength. HIV case‑based surveillance is well established and standardized, complemented by regular bio‑behavioural surveillance, key population size estimation, and sentinel surveillance.

Reflecting on the review findings, Nicole Segay, Team Lead, HIV Program Review, emphasized the importance of building on these foundations to accelerate progress. “Ending the HIV epidemic requires more ambitious targets for key populations, stronger data systems and routine use of disaggregated evidence to guide prevention, testing and treatment responses.” She said. 

Debriefing session Ms Nicole Segay, Team Lead, HIV Program Review, World Health Organization. © WHO Mongolia

Closing gaps to sustain gains 

Building on these achievements, the programme review outlined clear priorities to accelerate impact and sustain gains. Closing the remaining HIV detection gap is essential. This will require further intensifying targeted testing among key populations, using population size estimates to set more ambitious coverage targets, and expanding HIV self‑testing options – particularly for individuals reached through virtual outreach who do not attend physical service sites.

Scaling up and diversifying PrEP delivery is another priority. More ambitious PrEP targets, decentralized delivery models, and closer integration with community‑led and self‑testing services are recommended. The introduction of long‑acting PrEP formulations, in line with WHO guidance, could further improve uptake and adherence while strengthening overall prevention impact.

Maintaining confidence in testing services will require continued strengthening of quality assurance systems. Aligning national HIV testing algorithms with WHO recommendations, prioritizing procurement of WHO‑prequalified diagnostics, and expanding external quality assurance to subnational levels will help ensure accurate diagnosis.

Addressing the growing burden of STIs is equally important. Strengthening STI prevention, decentralizing access to timely treatment – particularly for syphilis – and expanding surveillance for gonococcal antimicrobial resistance will be critical to protecting recent gains and informing appropriate treatment policies.

Finally, improving data integration and use will be essential for sustained progress. Streamlining data systems, improving interoperability, and institutionalizing routine analysis of disaggregated programme data will enable more precise targeting, stronger performance monitoring, and better decision‑making. In parallel, focused investments in data quality and laboratory systems will support future validation of elimination of mother‑to‑child transmission, while sustainability planning will help ensure that community‑led services and programme achievements are maintained over the long term.

Together, these best practices and priority actions position Mongolia well to consolidate its gains and accelerate progress toward eliminating HIV and STIs as public health threats.