Thank you for the excellent questions! You are right to note the many potential challenges facing countries attempting to absorb donor-funded services into a publicly financed health insurance scheme. In additional to the operational and capacity issues that you noted, in some contexts questions arise regarding things like the management of patient privacy in public facilities and the future role of civil society and community-based organizations that often play important outreach, service delivery, and advocacy roles and rely on donor funding. There are examples of LMICs that have successfully incorporated HIV services into insurance schemes. I’m most familiar with Vietnam, which has started covering a package of HIV care and treatment services through social health insurance (SHI). This has required a range of steps, including accrediting and contracting with facilities delivering HIV services and/or relocating HIV service provision to multi-function facilities; defining and costing an HIV benefits package and forecasting its impact on the SHI scheme’s financial liabilities; developing a centralized procurement mechanism for ARVs and financial processes for SHI to purchase them; and exploring ways to protect PLHIV from the financial burden of SHI premiums and co-payments. Other countries’ experiences might also be instructive. For instance, even though none has a national-scale insurance scheme, Botswana, Namibia, and South Africa all finance the majority of their HIV responses and predominantly deliver ART through their regular public facilities. Additionally, a number of high-burden/generalized epidemic countries are actively considering new or reformed national/social health insurance systems, including Ghana, Kenya, Nigeria, South Africa, and Tanzania. They could surely learn a lot from each other as they grapple both with system design and more HIV-specific challenges.