The news may startle many but the fact is nearly one in every hundred, or may be a hundred of those you see on the road, would be suffering from HIV/AIDS.
Yes, India is estimated to have 5.2 million people living with HIV/AIDS, which is 0.88 per cent of the population. The number is also the second largest in the world after South Africa. The first case of HIV was detected in India in 1986.
In 1990, the government of India first initiated quite a few prevention-and-awareness programmes under the Medium Term Plan. Then the National AIDS Control Organisation came out with its first plan in 1992 which went on till 1999. The second plan started in 1999 and continued till 2006.
It is time for a new plan again, and NACO's new National AIDS Control Program will be launched this month. Here's a preview of the third NACP:
First two NACPs
For the first NACP, the World Bank was the major donor with $100 million (about Rs 410 crore) and as India did not have any experience in tackling the disease, whatever was prescribed by the World Bank was implemented by NACO. But the influence of the World Bank was less in the second plan as there were other donors too.
Indigenous third NACP
The difference between the first, the second and the third NACP is that the new plan is very participatory and democratically developed. The plan was chalked out keeping in mind the fact that the earlier initiatives have started showing results with signs of stabilisation in some parts of the country.
The third NACP was designed after talking to the NGOs, doctors, state level administrators and experts who were working in the field. People living with HIV/AIDS were consulted, so also their relatives. All these consultations were done through e-forums and one-on-one meetings. The plan also incorporated inputs from various assessments and studies. The process went on for one whole year.
The primary goal of NACP-III is to 'halt and reverse the epidemic in India over the next five years' by integrating programmes for prevention, care, support and treatment. The plan aims to achieve this through four stages.
Prevention
In the first year itself, NACP plans to reduce infections by 60 per cent in the high prevalence states and 40 per cent in the vulnerable states. As many as 163 of India's 611-odd districts have been designated 'high prevalence' areas and 59 districts are where the epidemic is concentrated.
At least 278 districts are in a group where increased presence of vulnerable population has been noted and 111 districts have been classified as of 'unknown vulnerability'.
The mainstay of NACP-III will continue to be prevention, as more than 99 per cent of the people in the country are HIV negative. The programme will focus on saturating the estimated 4 million high-risk groups like the commercial sex workers, intravenous drug users and MSM (men having sex with men), and the 12 million strong highly vulnerable populations namely migrants and truckers.
NACP III plans to access 95 per cent of the country's young through the ministries of youth affairs, human resource development, women and child development and the ministry of social justice and empowerment.
Testing
The major thrust of the plan is on testing. The new plan wants to increase the number of tests because the authorities feel only when more people are tested, can they unearth the real magnitude of the problem. 80 per cent of the people who go for testing at the voluntary counselling centres do so because of the advice of doctors.
Now, the government plans to have HIV testing as a routine one along with other routine tests unless a person objects to it.
'Only if people are tested, both prevention and care can be done. If the person is tested negative, he will be given prevention counselling, and if the person is tested positive, he will be given care and support,' the report says.
For example, Uttar Pradesh is categorised as a low prevalence state, possibly because very little testing is done there. Rs 7,786 crore (67.2 per cent of the total project outlay) has been set aside for testing.
At the end of the project period, the plan aims to have at least 21 million tests per year with 5,000 testing centres in the public sector and another 21 million tests by encouraging the private sector to routinely provide HIV testing.
Care, support and treatment
Once the testing is done, and the person is found to be HIV positive, care, support and treatment start. In the NACP-III, the plan will continue what is being used in the earlier plans.
The government says 785,000 people need anti-retroviral treatment (ART), but till August 2006 only 24,000 have received ART drugs from the state. It is estimated that NGOs provided ART to as many or more.
By 2011, the government hopes to provide treatment to at least 39,000 children and 300,000 adults. By 2011, this programme also plans to treat 3.2 lakh opportunistic infections in a year among the HIV/AIDS patients and provide TB referrals to 28 lakh PLHA (people living with HIV/AIDS).
The amount earmarked for this is Rs 1,953 crores, which is 16.9 per cent of the total project outlay.
Community Based Organisations
Another significant change that will be seen in the NACP is the creation of Community Based Organisations (CBOs) in place of NGOs. It is to promote the involvement of people living with HIV/AIDS and also those in the high risk group themselves in the programs, instead of just funding the NGOs. These CBOs will have sex workers, drug users, aravanis, etc forming their own groups and creating awareness among them. NACP plans to facilitate the establishment of several PLHA networks and civil society forums in each district by 2010.
