An Insight on World Aids Day: National AIDS Control Programme

By Special Correspondent

The National AIDS Control Organisation (NACO) was established in 1992 and the first National AIDS Control Programme (NACP) was launched. During Phase I of the NACP (1992- 1999), the focus was on awareness generation, controlling spread through blood, etc. Phase II of the programme was launched in 1999 with a strategic plan for HIV prevention. This plan established the administrative and technical basis for programme management and also set- up State AIDS Societies to streamline response to HIV/AIDS at the state level. It was during this phase that specific interventions were targeted toward FSWs, MSM, IDUs and policies for blood banks for screening for HIV were also introduced. ART was rolled out in the country in 2004. With a rich learning of about two decades, NACP-III aimed for a holistic AIDS response and focussed on (i) Prevention of new infection in HRG and general population, (ii) Greater care, support and treatment to larger number of PLHA, (iii) Strengthening the infrastructure, systems and human resources at the district, state and national level and (iv) Strengthening the nationwide Strategic Information Management System. Core to the NACP-III was “Scale- up across prevention, testing and treatment” as AIDS response received good advocacy and a favourable funding environment.

Consolidating the gains made in the first three phases on National AIDS Control Programme, the fourth phase was launched in 2012 with goal to ‘Integrate response and accelerate reversal’ by 2017. Focus of NACP-IV was on consolidation, quality and integration. Achievements of almost two decades were consolidated by sustaining prevention focus while effectively addressing the ever-growing challenges of treatment need. Equal importance has been provided on ensuring higher quality of services under interventions while sustaining the coverage. Widening the net of and ensuring access to social protection schemes for people infected and affected with HIV/AIDS through mainstreaming of HIV/AIDS with other ministries was a specific focus.

 Stigma & Discrimination

Stigma and discrimination faced by people living with HIV is biggest obstacle in the way of effective responses to HIV. Stigma is still prevailing against the people infected and affected with HIV especially, at work place, healthcare settings and educational institutions.

Tripura State AIDS Control Society envisions:

● Building an integrated response by reaching out to diverse populations.

● Achievement of development objective

● Regular dissemination of transparent estimates on the spread and prevalence of HIV/AIDS

● Building a state where every person is safe from HIV/AIDS

● Building partnerships

● A State where every person has accurate knowledge about HIV and contributes towards eradicating stigma and discrimination

● A State where every pregnant woman living with HIV has the choice to bring an HIV free baby into the world

● A State where every person has access to Integrated Counselling & Testing Centres (ICTCs)

● A State where every person living with HIV is treated with dignity and has access to quality care

● A State where every person will eventually live a healthy and safe life, supported by technological advances

● A State where every person who is highly vulnerable to HIV is heard and reached out to

The followings are the main components of HIV/AIDS Control Programme in Tripura: 

Targeted Intervention: 

Objective of the component Targeted Intervention (TI) is one of the major sub-components under ‘Prevention’ component of the National AIDS Control Programme (NACP) –IV. As the overall goals of the NACP –IV to reduce new infections by 50 % (2007 base line of NACP-III) and comprehensive care, support and treatment to all persons living with HIV/AIDS; therefore, highest priority has been given to cover the sub-populations that have the highest risk of exposure to HIV through intervention programmes. This High-Risk Group (HRG) includes Female Sex Workers (FSWs), Injecting Drug Users (IDUs) and Man Having Sex with Man (MSMs). Also high priority in intervention programme is accorded to Migrant Labourers (ML) and long-distance Truckers. Total 14 TI projects are running across the Tripura State.

Integrated Counselling & Testing:  

An Integrated Counselling and Testing Centre (ICTC) is a place where a person is counselled and tested for HIV, on his own free will or advised by a medical provider. The main functions of an ICTC are - Early detection of HIV, basic information on modes of transmission and prevention of HIV/AIDS, Link people with other HIV prevention, care and treatment services. In our State there are 24 nos. Stand Alone ICT Centres and 130 nos. FICTC (Facility Integrated ICTC), and 3 PPP ICTCs and 1 Mobile ICTC are functioning throughout the State.  

Blood Transfusion Services: 

Blood transfusion services play a vital role in the Health care delivery system. The Blood Safety program of National AIDS Control Program is targeting Low Risk population by providing adequate and safe Blood for those who seek Blood Transfusion Services in Hospitals / First Referral Units (FRUs) functioning in the State. Tripura State AIDS Control Society aims to ensure easily accessible and adequate supply of safe and quality Blood & Blood components from a voluntary non-remunerated regular Blood donor in well-equipped premises, which is free from Transfusion Transmitted Infections (TTI), and is stored and transported under optimum conditions. Tripura State AIDS Control Society aims to reduce transmission of HIV infection through Blood and Blood products by reducing the Sero-reactive rates among the Blood donors. All the Blood Units collected in the Blood Banks are mandatorily tested for 5 TTI markers namely HIV (I & II), HBV, HCV, Malaria, and Syphilis as per the rules laid down in the Drugs and Cosmetics Act 1940.

Information, Education and Communication (IEC):

 Information, Education & Communication: The focus of IEC activities has been on promoting safe behaviours, reduction of HIV stigma and discrimination, demand generation for HIV/AIDS services, and condom promotion. Mass media campaigns were synergised with other outreach activities and mid-media activities. Adolescence Education Programme is being implemented in States covering 500 schools. Red Ribbon Clubs are functional in 29 colleges throughout the State. 

Mainstreaming: 

Mainstreaming facilitates the expansion of key HIV/AIDS services through integration with health systems of various stakeholders and designs policies, programmes and schemes to support social protection needs of PLHIV and HRG. Initiatives are being taken for strengthening convergence of NACP.

Sexually Transmitted Diseases (STD): 

STD Clinics are meant for syndromic management of Sexually Transmitted Infection (STI)/Reproductive Tract Infection (RTI) for syndromic treatment and control and management, as persons suffering from STI/RTI are more vulnerable to acquire and transmit of HIV among the population. So, STD Clinics are established for prevention and treatment of STI/RTI to control the spread of HIV. For the above stated purpose, at present total 18 nos STD Clinics are established in 8 (eight) districts of Tripura which are as follows: In all the STI clinics, STI/RTI diseases like Gonorrhoea, Clamydia, Syphillis, Chancroid, Lympho Granoluma Venereum, Herpis Symplex, Vaginal Discharge, Cervical Discharge, Pelvic Inflamatory Diseases (PID), Inguinal Bubo (IB), Scrotal Swelling etc. are syndromically diagnosed and syndromically treated with STI/RTI Drugs freely supplied by Government. 

 

Care, Support and Treatment:

 The Care, Support and Treatment (CST) needs of HIV positive people vary with the stage of the infection. The HIV infected person remains asymptomatic for the initial few years; it manifests by six to eight years. As immunity falls over time the person becomes susceptible to various opportunistic infections (OIs). At this stage, medical treatment and psycho-social support is needed. Access to prompt diagnosis and treatment of Opportunistic infection ensures that PLHAs live longer and have a better quality of life.

Strategic Information Management System: 

Strategic Information Management System (SIMS) is a web-based integrated monitoring and evaluation system that allows capture of the data directly from various levels such as reporting units, districts, and States, and enables it to be viewed anywhere on a real time basis. It undertakes automatic aggregation of key indicators that can be reviewed through standard and customised reports at any level. It enhances the efficiency of the computerised M&E system by ensuring adequate data quality through centrally validated data. It can be integrated with all other data bases such as Surveillance, PLHIV database, other survey data etc. It enables capture of individual level information from Counselling and testing centres and ART centres, with all security measures to ensure data confidentiality of personal information. It is modular, expandable & scalable with slice & dice capabilities. SIMS also provides tools for better decision-making through data triangulation from different sources and thereby facilitates ease of evaluation, monitoring and taking policy decisions at strategic or tactical levels.