Family Planning Association of India celebrates the 26th anniversary of World AIDS Day. First observed in 1988, World AIDS Day was initiated 
The theme for this year’s observance is, “Getting to Zero” – meaning zero new HIV infections, zero discrimination, and zero AIDS related deaths. The special theme, which will be repeated until 2015, focuses on “Zero AIDS Related Deaths” and signifies a push towards greater access to treatment for all. Perhaps more importantly, it also calls upon governments to keep the commitments they have made to fight the deadly disease.
Although AIDS remains one of the world’s most serious health challenges, global solidarity in the AIDS response during the past decade continues to generate extraordinary health gains. Historic success in bringing HIV programmes to scale – combined with the emergence of powerful new tools to prevent people from becoming infected and from dying from AIDS-related causes – has enabled the foundation to be laid for the eventual end of AIDS. Although much of the news on AIDS is encouraging, challenges remain. In 2012, 60% more people have accessed lifesaving HIV treatment, with a corresponding drop in mortality. New infection rates have fallen by 50% or more in 25 countries. Half of all the reductions in HIV infections in the past two years have been among children; this has strengthened conviction that achieving an AIDS-free generation is not only possible, but imminent.
INDIAN SCENARIO
The adult HIV prevalence in India is 0.27%, as of 2011. Whilst this figure is small relative to other middle-income countries, the large population of 1.2 billion inhabitants means there are still around 2.1 million people living with HIV in India. Overall, India’s HIV epidemic is slowing down, with a 57% decline in new infections between 2000 and 2011, and a 29% decline in AIDS-related deaths between 2007 and 2011.
India’s HIV epidemic varies across its 28 states. The four states with the highest number of people living with HIV (Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu) are all in the south, and account for 53% of all HIV infections in India. Despite this, the adult HIV prevalence is falling in these high prevalence states. However, in a few states in the north and northeast, HIV infections are rising.
The epidemic is concentrated among high risk group populations and is heterogeneous in its spread. The primary drivers of HIV epidemic in India are unprotected paid sex, unprotected sex between men and injecting drug use. Heterosexual route of transmission accounts for 87% of HIV cases detected. Improved understanding of the complex HIV epidemic in India has enabled substantial changes to be made in the policy frameworks and approaches of National Aids Control Programme (NACP). The focus has shifted from raising awareness to behaviour change, from a national response to a more decentralised response and to increasing involvement of NGOs and network of PLHAs.
In 1992, the Government launched the first National AIDS Control Programme (NACP I) and in 1998 NACP II was initiated. Based on the learning from NACP I and II, the Government designed and Implemented NACP III (2007-2012) with an objective to “halt and reverse the HIV epidemic In India” by the end of the project. NACP III has given desired results and has been quoted as a global success. NACP IV (2012-17) aims to consolidate the gains of NACP III.
The main objectives of NACP IV are to: (i) Reduce new infections by 50 percent, and (ii) Provide comprehensive care and support to all persons living with HIV and treatment services for all those who require it. This will be achieved through the following strategies:
a. Intensifying and consolidating prevention services with a focus on (a) high-risk groups and vulnerable population and (b) general population.
b. Expanding IEC services for (a) general population and (b) High-Risk Groups (HRGS) with a focus on behaviour change and demand generation.
c. Increasing access and promoting comprehensive Care, Support and Treatment
d. Building capacities at National, State, District and facility levels
e. Strengthening Strategic Information Management Systems.
The Department of AIDS Control has been working closely with the Department of Health and Family Welfare towards integration of HIV & AIDS services into the larger health system, with the objective of optimal utilization of existing National Rural Health Mission (NRHM)/RCH resources for strengthening NACP services, and vice versa.
FPA India’s Contribution
FPA India a Non Governmental Organisation working in the field of Sexual and Reproductive Health over the 60 years started its work with HIV and AIDS in 1990 and is contributing substantially in reaching out to the communities they work with and ensure a comprehensive, integrated model within the larger sexual reproductive health framework.
Besides this, FPA India also implements projects supported by other donors like Morris foundation, Aum Foundation and Japan Trust Fund at seven locations.
Today, working in partnership with the GOI, under their public private partnership, 27 Integrated Counselling & Testing Centres (ICTCs) are functioning in the FPA India clinics, 18 Targeted Intervention Projects are being implemented with support from the state governments and international donors to provide services to the high risk groups such as sex workers, IDUs, MSM, migrant workers and transgender.
Source : Ashwati R Nair