National AIDS Control Programme (NACP)-III

Preparatory Phase

National AIDS Control Organization

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NACP III • NACP III Planning Team constituted with:

- Mr.R.K. Mishra, Team Leader

- Dr. Bhagbanprakash, Lead Member, HRD, Research & Trg

- Dr. Sadhana Rout, Lead Member, IEC & Social Mobilization

- Dr. K. Sudhakar, Lead Member, M&E

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Current Scenario

• 1 Case in 1986 - 5.134 million by 2004• Second only to South Africa • Globally, 1 out of every 8 persons living with

HIV is an Indian • HIV prevalence among adult population at

0.92%• 6/35 states > 1% prevalence• 111/604 districts > 1% prevalence

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Changing Face of Epidemic

Movement from …• High risk groups to general population• Urban to rural areas• High prevalence states to all states• Feminisation• High vulnerability of youth

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NACP III : Priorities and Thrust Areas

• Project to Program mode

• NACO’s changing role: implementation agency to a program catalyst

• Strengthening the state level response: thru organizational restructuring and capacity building

• Building on the gains of NACP II and reaching out to the district level

• Priority for prevention and strengthening of care, support and treatment programs

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NACP III: Priorities and Thrust Areas

• Increased focus on vulnerable states and NE states

• Up-scaling and Improving service delivery

• Establishing robust M&E system at all levels

• Increased attention on mainstreaming and partnership development

• Evidence based planning, program implementation and financial management

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Assumptions….Prevention

• Targeted interventions are still a valid approach (i..e. saturation of high risk groups and “partners” )

• Public and private sector will play a key role in increasing compliance with national guidelines on blood safety, injection safety and infection control

• All vulnerable populations will be fully aware of HIV transmission and control

• Highly populous states like UP, Bihar, Rajasthan and MP will show greater ownership and stronger response

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Assumptions….• Migrant groups will have increased access to quality

interventions at source and destination

• Public and corporate sectors will have HIV budget

Care, support and Treatment

• Increased access and stigma reduction will lead to greater use of services (VCTC, PMTCT, STI and ART)

• Sustained availability of resources for drugs, diagnostic facilities

• Public and private sector will play a key role in providing quality, care and support services at all levels

• Families and communities will provide services for PLHIV

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AssumptionsCapability Development

• NACO and SACS fully staffed with qualified professionals and minimal turnover

• States will invest in human resources and institutional strengthening as a priority

• Civil society will be fully engaged in prevention and care programs

Monitoring and Evaluation Systems

• Stakeholders will share data regularly• Implementing units will use the information for

program planning

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NACP III Planning Process

The approach:

• Three Ones• Participatory Planning• Increased ownership at state and district levels• Mainstreaming • Partnerships

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NACP III Planning ProcessThe Process

• Working Groups• State level consultations for frame work

development• District and State level Program Implementation

Plans (PIPs)• Commission studies or assessments• Collaboration with Development Partners (DP) • Consultations with NGOs, civil society, public-

sector, private sector and other interest groups• National PIP

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Summary Update

• Draft Framework and Timeline for the NACP-III preparatory phase developed

• World Bank PHRD Grant agreement for studies / assessments finalized

• Field visits: DSACS, APSACS, UPSACS • State Program Managers Groups (SPMG) met in

Chennai, Bangalore and Kolkata • Finance working group met in Chandigarh• Meetings with partners : ongoing• E-Consultation for civil society participation being

launched

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Working Groups and conveners

• Targeted Interventions - Dr.Thomas Philip,SHRC

• Gender,Youth,Adolescents,Children -Dr Sunil Mehra, MAMTA

• Communication,Advocacy and Community Mobilization. - Dr Krishnamurthy, PD,APAC,Chennai

• GIPA,Human Rights,Legal and Ethical issues . - Mr. K.Rajan,PD Kerala SACS

• Care,Support and Treatment. - Dr Dharamshaktu,APD,NACO

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Working Groups and conveners• Service Delivery -Dr. Dharamshaktu, APD,NACO

• STI/RTI Treatment and Convergence with RCH - Mr. James Blanchard,ICHAP • Condom Programming. - Mr. Amit Jain,Head of Social Marketing HLFPPT

• Mainstreaming and Partnerships - Ms Damayanthi,PD APSACS

• Programme Management, Programme implementation and organizational restructuring - Mr. Vijay Kumar, PD, TNSACS

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Working Groups and conveners

• Financial Management- Director Finance, NACO

• Epidemiological Surveillance-Dr. Shaukat, JD, NACO

• Research,Development and Knowledge Management-Dr. Vijayaluxmi Bose, Consultant, NACO

• Monitoring Evaluation-Dr. M. Shaukat, JD, NACO

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E-Consultation

A partnership project of UNAIDS and NACO

Objectives:• To provide inputs from all stakeholders to the

working groups in particular• To inform the NACP III Planning process in general

Public website: http://www.unaids.org.in/nacp3discussion

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Studies:-

Situation analysis in rural areas & High Risk Groups (other than those covered by TIs)

MSM sexual attitudes & practices vis a vis sexual transmission percentage

National & State level response including Public & Private sectors.

Effectiveness of existing IEC / BCC efforts

Studies/Assessments (under PHRD Grant)

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Assessments: Rapid Survey on health care workers’ attitude

(Public & Private.) Existing M&E system. Resources needed to provide ART in selected

states. Existing strategy / implementation of TI (CSWs,

truckers and other clients of CSWs I.e. migrant workers, IDUs, MSMs, street children)

Social Marketing efforts

Studies/Assessments (under PHRD Grant)…

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NACP III : Proposed Framework

1. Executive SummarySection I

2. Program Description2.1 Background2.2 Initial response of the government of India (1986-90)2.3 Medium-Term Plan with WHO Collaboration (1990-92)2.4 National AIDS Control Program (NACP) I&II (1992-2005)2.5 Limitations in the Implementation of the NACP

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3. Current situation4. Lessons Learned and Key Sector Issues 5. Social, institutional, environmental & NGO

Assessments6. National AIDS Prevention and Control Policy

(2002)7. Expanded National AIDS Control Programme 8. Third Phase of the NACP (2006-2011)

Proposed Framework…..

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9. Program Development Objectives

9.1 Program Strategies9.2 Monitoring, Evaluation and MIS9.3 The Process of Program Preparation9.4 Implementation Arrangements9.5 Multi- Sector Issues

10. Program Cost Summary

Proposed Framework…..

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Section II

11. National AIDS Control Program Phase III (2006-11)

Prevention : Objective # 1

Prevent new infections (Zero rate of growth by 2007)

A. Saturation of Targeted Interventions for high risk groups/high risk areas

a) Expansion of coverage of HRGs (quality STI and condom promotion services)b) Increased involvement of PLHIV, NGOs, CBOs and civil societyc) Reducing stigma, discriminationd) Integration of care and treatment activitiese) Prevention programs for PLHIV

Proposed Framework …

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B. Scaling up of interventions among highly vulnerable populations

a) Increasing awareness, bcc activities, community mobilization, advocacy

b) Focused efforts on gender, youth, adolescents and children

c) Expanding workplace interventions d) Focused efforts on migrant populations and cross-

border areas e) Improved access to quality condom and STI

services

Proposed Framework…Prevention : Objective # 1….

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Care, Support and Treatment: Objective # 2

Increase in proportion of PLHAs receiving care, support and TreatmentC. Care, Support and Treatment a) Improving treatment access for OIs, STI/RTI b) Developing capacity for ART roll out and increasing delivery of ART c) Expansion of PPTCT and PEP programs d) Community care and support programs e) Integration of prevention measures and linkages with TIs f) Collaboration with PLHA networks

Proposed Framework ..

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D. Improving service delivery at district, state and national levels

a) Improving condom promotion, STI Care, VCTC and PPTCT

b)Ensuring safe blood, injections, diagnostics and infection control

c) Support to PLHAs, NGOs, CBOs and, networks

Proposed Framework ….Capability Development: Objective # 3Strengthening the capabilities at district, state and national levels (infrastructure, ,systems & human resources)

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E. Mainstreaming HIV/AIDS and Partnership development

a) Convergence with RCH, TB and other MOHFW projects

b) Mainstreaming (government departments/agencies and other public sector institutions)

c) Partnerships (private sector, voluntary & faith based groups, CBOs & civil society)

d) Coordination with donors, stakeholders and interest groups

Proposed Framework ….Capability Development: Objective # 3….

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Proposed Framework ..

Monitoring and Evaluation: Objective # 4

F. Establishing one nationwide monitoring and evaluation system

a) Improving strategic planning, management capability

b) evidence based planning and effective use of information for program implementation

c) Strengthening research, development and knowledge management

d) effective linkages between technical and financial management systems

e) pooling of funds and Joint reviews

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NACP III : Outcomes ……• Reduction in number of high prevalence

districts (from … to….)• Ensuring the vulnerable districts remain

low prevalent• increased consistent condom use among

high risk groups (from … to…)• Decreased number of partners among

vulnerable populations• Increased use of quality services (VCTC,

STI, blood banks)• Increased number of pregnant women

receiving PPTCT services (from….to…)•

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NACP III: Outcomes….

• Increased number of PLHAs receiving ART (from…to…)

• Increased number of organizations that practice GIPA (from ….to…)

• Number of states and districts with established HIV/AIDS committees chaired by political leaders

• Number of states and districts with HIV/AIDS consortiums of public and private partners

•

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Proposed Timeframe…

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Proposed Timeframe…

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Proposed Timeframe…

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Proposed Timeframe

34THANK YOU