National AIDS Control Organization(NACO)

National AIDS Control Organisation 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 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.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 Organisation (NACO) was constituted to implement the programme. The objective of NACP-I (1992-1999) was to control the spread of HIV infection. During this period a major expansion of infrastructure of blood banks was undertaken with the establishment of 685 blood banks and 40 blood component separation. Infrastructure for treatment of sexually transmitted diseases in district hospitals and medical colleges was created with the establishment of 504 STD clinics. 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.
During NACP-II (1999-2006) 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). The package of services in these interventions includes Behaviour Change Communication, management of STDs and condom promotion. The School AIDS Education Programme was conceptualised to build up life skills of adolescents and address issues relating to growing up. All channels of communication were engaged to spread awareness about HIV/AIDS, promote safe behaviours and increase condom usage. Voluntary counselling and testing facilities were established in healthcare facilities to promote access to HIV counselling and testing. The interventions for prevention of parent to child transmission were also started. 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. Apart from this, some policy initiatives during NACP-II included National AIDS Prevention and Control Policy, National Blood Policy, a strategy for Greater Involvement of People with HIV/AIDS and National Rural Health Mission.
The National AIDS Control Programme (NACP) Phase – III (2007 – 2012) had 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: a) Prevention of new infections in high – risk groups and general population; b) Providing greater care, support and treatment to larger number of persons living with HIV/AIDS (PLHA); c)Strengthening the infrastructure, systems and human resources in prevention, care, support and treatment programmes at the district, state and national level;d) Strengthening the nationwide Strategic information Management System.
On February 12, 2014 Government of India launched the fourth phase of its anti-AIDS/HIV strategy, the National AIDS Control Programme, NACP VI. The five year programme (2012-17) aims at sustaining and building up on the results of NACP III Phase, which lasted from Jul 2007 to mid 2012. The two years lag in the next phase has been attributed to shortage of funds due to unavailability of donors.
Highlights of NACP IV:

• Reversal of AIDS epidemic through a participative/inclusive approach
• Targeting High Risk Groups (HRG) – truckers, migrants, pregnant women, etc
• Strengthening the response in India through a cautious and well defined integration process (testing and counselling)
• Wide range discussions with stakeholders – people living with AIDS, Civil Society, NGOs, positive networks, communities, technical experts, and government representatives from state and other central Ministries
• Promotion of condoms (free distribution) in particular female condoms and other prevention mechanisms and awareness
• Up-scaling the Anti Retroviral Therapy (ART) and administering third line of it to those who failed in the second line of treatment
• Social protection by curbing discrimination to reduce vulnerability of families suffering from AIDS
• The budgetary allocation for NACP-IV for five years is Rs.14,295.05 crore which is funded partly by the Global Fund and the World Bank. Global Fund also offers us grant to fight Tuberculosis and Malaria.
• Parent-to-child transmission prevention
• Phase wise Integration of HIV services with the health system
• Effective use of strategic information at various levels – state, central, department

A National Council on AIDS chaired by the Prime Minister and consisting of 31 ministries, seven chief ministers, civil society representatives, positive people's network and private sector organisations was constituted with the following objectives:

• To mainstream HIV/AIDS issue in all ministries and departments by treating it as a development challenge and not merely a public health problem.
• To provide leadership to mount multi-sectoral response to combat HIV/AIDS in the country with special reference to youth, women and the workforce.

By: Vishal