 Much of the Enhanced Program services are contracted out and delays in procurement of these services meant that many of the cities went without services for months to years.More complex (and longer term) challenges will include determining how to integrate many of HIV activities within other health activities, improve planning to anticipate future direction of the epidemic and its response and to enhance efficiency and effectiveness of the interventions.For these research must become part of the interventions to guide their implementation using local context and to involve epidemiological tools such as routine analysis of available data and even mathematical modeling to guide program planning.