National AIDS Control Programme

Human immunodeficiency virus (HIV) is retrovirus. It is also known as human T-lymphotropic virus-III (HTLV-III), lymphadenopathy-associated virus (LAV), and AIDS-associated retrovirus (ARV). Transmission involves anal, vaginal or oral sex, blood transfusion, contaminated hypodermic needles, exchange between mother and baby during pregnancy, childbirth, breastfeeding or other exposure to one of the above bodily fluids.

Effects of AIDS

• Due to weakened immune system the person is attacked by infections caused by bacteria, viruses, fungi and parasites that are normally controlled by the elements of the immune system that HIV damages.
• Opportunistic infections are common in people with AIDS. HIV affects nearly every organ system.
• People with AIDS may develop various cancers such as Kaposi’s sarcoma, cervical cancer and cancers of the immune system known as lymphomas.
• Besides the people infected with AIDS often have systemic symptoms of infection like fevers, sweats (particularly at night), swollen glands, chills, weakness, and weight loss.

AIDS Control Efforts in India:

• First cases of HIV were diagnosed among sex workers in Chennai in 1986.
• Following the detection of the first AIDS case in the country, the National AIDS Committee was constituted in the Ministry of Health and Family Welfare.
• By the end of 1980s a spread of HIV was observed among injecting drug users (IDUs) in Manipur, Mizoram and Nagaland.
• As the epidemic spread, need was felt for a nationwide programme and an organisation to steer the programme.
• In 1992 India’s first National AIDS Control Programme (1992-1999) was launched, and National AIDS Control Organization (NACO) was constituted to implement the programme.
• National AIDS Control Organization is a division of the Ministry of Health and Family Welfare that provides leadership to HIV/AIDS control programme in India through 35 HIV/AIDS Prevention and Control Societies.
• In 1992 Govt. set up State AIDS bodies in 25 states and 7 union territories.
• In 1992 India’s first National AIDS Control Programme NACP-I (1992-1999) was launched, and National AIDS Control Organisation (NACO) was to implement the programme.
• The objective of NACP-I (1992-1999) was to control the spread of HIV infection. During this period 685 blood banks & 504 STD clinics were established. HIV sentinel surveillance system was also initiated. NGOs were involved in the prevention interventions with the focus on awareness generation. The programme led to capacity development at the state level with the creation of State AIDS Cells in the Directorate of Health Services in states and union territories.
• NACP-II (1999-2006) was launched during which a number of new initiatives were undertaken and the programme expanded in new areas.
• Targeted Interventions were started through NGOs, with a focus on High Risk Groups (HRGs) viz. commercial sex workers (CSWs), men who have sex with men (MSM), injecting drug users (IDUs), and bridge populations (truckers and migrants).
• Behaviour Change Communication, management of STDs and condom promotion were included.
• The School AIDS Education Programme was conceptualized.
• Voluntary counselling and testing facilities were established.
• Free antiretroviral therapy was initiated in selected hospitals in the country.
• Development of indigenous vaccine and research on microbicides are some initiatives in HIV research.
• National AIDS Prevention and Control Policy & National Blood Policy, a strategy for Greater Involvement of People with HIV/AIDS and National Rural Health Mission.
• AIDS control societies were granted funding for youth campaigns, blood safety checks, and HIV testing, among other things.
• Various public platforms were used to raise awareness of the epidemic – concerts, radio dramas, a voluntary blood donation day and TV spots with a popular Indian film-star.
• Messages were also conveyed to young people through schools. Teachers and peer educators were trained to teach about the subject, and students were educated through active learning sessions, including debates and role-play.
• This program finished in March 2006.

National AIDS Prevention and Control Policy

In 2001, the government adopted the National AIDS Prevention and Control Policy.

National AIDS Control Programme

In 2006 UNAIDS estimated that there were 5.6 million people living with HIV in India, which indicated that there were more people with HIV in India than in any other country in the world. India has now developed the Third National AIDS Programme Implementation Plan (2007-2012). The programme has a budget of around $2.6 billion, two thirds of which is for prevention and one sixth for treatment. Aside from the government, this money will come from non-governmental organisations, companies, and international agencies, such as the World Bank and the Bill and Melinda Gates Foundation.

The National AIDS Control Programme (NACP) Phase – III (2007 – 2012) has the overall goal of halting and reversing the epidemic in India over the five year period. It seeks to integrate prevention with care, support and treatment through a four – pronged strategy:

1. Prevention of new infections in high – risk groups and general population.
2. Providing greater care, support and treatment to larger number of persons living with HIV/AIDS (PLHA).
3. Strengthening the infrastructure, systems and human resources in prevention, care, support and treatment programmes at the district, state and national level.
4. Strengthening the nationwide Strategic information Management System.

In 2009 India established a “National HIV and AIDS Policy and the World of Work”, which sough to end discrimination against workers on the basis of their real or perceived HIV status. Under this policy all enterprises in the public, private, formal and informal sectors are encouraged to establish workplace policies and programmes based on the principles of non-discrimination, gender equity, health work environment, non-screening for the purpose of employment, confidentiality, prevention and care and support.

TeachAIDS

In 2010, NACO approved the TeachAIDS curriculum for use in India, an innovation which represented the first time that HIV/AIDS education could be provided in a curriculum which did not need to be coupled with sex education. Later that year, the Government of Karnataka approved the materials for their state of 50 million and committed to distributing them in 5,500 government schools.

Red Ribbon Express

On World AIDS Day 2007 India flagged off its largest national campaign to date, in the form of a seven-coach train the Red Ribbon Express (RRE) This train travelled across 24 states during its one year journey, halting at 180 stations, covering a distance of over 27,000 km and reaching around 6.2 million people with HIV/AIDS education and awareness. It was world’s largest social mobilization campaign against HIV/AIDS by the United Nations Children’s Fund (UNICEF).

• Red Ribbon Express is an AIDS/HIV awareness campaign train by the Indian Railways. The motto of the Red Ribbon Express is “Embarking on the journey of life”.
• The Red Ribbon Express was launched in India on World AIDS Day, December 1, 2007. It has emerged as the world’s largest mass mobilization programme against HIV/AIDS.
• The Red Ribbon Express’ second phase was flagged off on World AIDS Day, 2009.
• In the 2^nd phase the National Rural Health Mission has also come on board with NACO. Along with the three exhibition coaches with exhibits on HIV/AIDS, the fourth exhibition coach is on NRHM with exhibits of H1N1, Tuberculosis, Malaria, Reproductive and Child Health services, general health and hygiene.
• The 3^rd phase of Red Ribbon Express was launched on 12^th January 2012. The train will not only provide counselling but also help people in testing and anti-retro viral treatment.