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National AIDS Control Organization7th ICAAP Kobe 2nd July 2005

Mainstreaming HIV/AIDS -

A multi-sectoral approach:

The Indian Perspective

Dr.S.Y. QuraishiDirector General, NACO

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Status of Epidemic

• 1 Case 1986 - 5.134 million by 2004

• HIV prevalence among adult population at 0.92%

• 6/35 states > 1% prevalence

• 111/604 districts > 1% prevalence

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HIV Prevalence at ANC Site <1

HIV Prevalence at ANC Site 1-2

HIV Prevalence at ANC Site 2-3

HIV Prevalence at ANC Site >=3

Source: NACO’s Sentinel Surveillance data: ANC sites (2001, 2003)

Sub National Epidemics

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Changing face of Epidemic

Movement from• High risk groups to general people

• From the urban to rural areas

• From High Prevalence states to all states

• Feminisation

• Youth vulnerability high

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National AIDS Control Program II: 1999-2006

• Reduce growth of HIV infection•Targeted Intervention in HRG•Prevention in general population•Low cost care and support

• Increase country’s capacity to respond to HIV/AIDS

•Institutional strengthening•Inter-sectoral collaboration

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Mainstreaming : Challenges

• Federal structure and diversity• Migration of 180 million people per

year, both intra-state and inter-state• 26% population below poverty line• Literacy rate of 65%• Prevalence of non-regular sex • Sex education still considered taboo • Poor social status of women

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National Mandate

• National Common Minimum Programme : Increase outlay of Health Sector to 2-3% of

GDP Focus on Communicable Diseases UPA will provide leadership to National AIDS

Control efforts

• Prime Minister to lead National AIDS effort

• National AIDS Control Policy 2002 committed to zero rate of growth by 2007 (0 X 7)

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To accomplish the National Mandate

We require:

• Safe practices by all

• Full awareness

• Comprehensive service delivery to the entire population

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Mainstreaming HIV/AIDS in programs of all government departments & civil society partners including corporate sector

The Approach

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Mainstreaming: Political leadership

• National Council on AIDS headed by Prime Minister

• Inter-ministerial group preceded NCA

• Parliamentary /legislative forums• Local Self Government Institutions

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Mainstreaming: Government programs

• Education: Integration of HIV in school education

• Women & Child Development• Youth and Sports• Rural Development

• Labour

• Social Justice & Empowerment

• Information and Broadcasting

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Mainstreaming: Government programs (contd…)

• Defence and Paramilitary• Home Affairs / Internal security• Transport• Railways• Steel, Coal and Mines• Chemicals and Fertilizers• Industry and Commerce

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NACO’s Changing Role

• From sole implementer to catalyst• Advocacy• Technical Support• Capacity Building• Joint Monitoring

• Shared ownership• HIV/AIDS integrated in partners budget

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A model.. Partnering with Dept. of Education

• Integration of HIV prevention content into the curriculum and textbooks

• Coverage of secondary & higher secondary schools through co-curricular activities (School AIDS Education Program)

• Linkages with National Open University, Open school, Indian Technical Training centers

• Integration in pre-service and in-service teacher training

• Linkages with programs of elementary

education, adult education and out-of-school

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Ministry of Home Affairs

Taskforce created

• Re-look at legal provisions impeding HIV/AIDS prevention

• Situation analysis of Police forces• Training for own safety• Supporting NGOs working with CSWs, MSMs,

IDUs• MHA to fund the program from its own

budget

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• Workplace Policy• Reduction of stigma and discrimination• Awareness Program• Care, Support and Treatment• Condom promotion

• Help in condom distribution • Piggyback HIV/AIDS messages in

corporate advertisement• Facilitate trade unions involvement

Mainstreaming with Corporate Sector

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Civil Society Partnership

• More than 1000 CBOs/NGOs are implementing important programs like:

•Targeted interventions•Community care centers

• PLWHA part of all decision making bodies

• NGOs/CBOs integrate HIV/AIDS issues in their ongoing programs

• Faith based organizations

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Process of Mainstreaming

• Political leadership- crucial• Ownership of program by all sectors• Allocation of funds within ministries

/sectors• Building capacity• Sustainable institutional mechanisms• Robust monitoring and evaluation

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Unique initiative: PACT India

Partnership on

AIDS

Control and

Treatment

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PACT India partners• Political leaders / Parliamentary forum• Ministries and Department of government• Corporate enterprise• Networks of PLHAs• Media• Legal associations• Private health care providers• NGOs and CBOs• Religious and faith leaders• University, colleges and other academic

institutions• Trade unions• Service clubs (Rotary, Lions, etc)• UN, bilateral and other International entities

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National AIDS Control Program

Three Ones Plus:

• One national program• One national authority• One monitoring and evaluation

framework

Plus…• One National Partnership

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One Nation, One Resolve: We will defeat AIDS

Together

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THANK YOU