Amity Institute of Hospital Administration

National Aids Control Programme

Submitted by: Dr. Divya Kapoor

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Introduction
Launched in India in the year 1987.

Aim of the programme:

Prevent further transmission of HIV. To decrease morbidity and mortality associated ith HIV infection. To minimi!e the socio"economic im#act resultin$ from HIV infection.

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ilestones
198% : first case of HIV detected & 'I() tas* force set by I+,-. 199. : medium term #lan launched for / states 0 / metro 1991 : 2'+P 1 launched 0 2'+3 constituted. 1999 : 2'+P 1 be$ins & )'+) established 1..1 : 2'+P ado#ted. 1../ : '-V Treatment started. 1..7 : 2'+P 4 launched for 5 years . 1.11 :2'+P / launched for ne6t 5 year .

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!outes of transmission of "I#

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Current Scenario
HIV situation in the country is assessed and monitored through regular annual sentinel surveillance established since 1992. There are 1.8 - 2.9 million (2.31 million !eo!le living "ith HIV#$I%& at the end o' 2((). The estimated adult !revalence in the country is (.3*+ ((.2,+ - (.*3+ and it is greater among males ((.**+ than among 'emales ((.23+ . The overall HIV !revalence among di''erent !o!ulation grou!s in 2(() continues to !ortray the concentrated e!idemic in India- "ith a very high !revalence among High .is/ 0rou!s - I%1 ().2+ - 2&2 ().*+ - 3&4 (,.1+ 5 &T% (3.6+ and lo" !revalence among $78 clinic attendees ($ge ad9usted - (.*8+ .

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Components of the programme

7stablishments of surveillance centres Identification of hi$h ris* $rou# and their screenin$ Issuin$ $uidelines for mana$ement of detected cases and their follo "u# 8ormulatin$ $uidelines for blood ban*& blood #roduct manufacturers& blood donors and dialysis unit Information& education& and communication activities +ontrol of se6ually transmitted diseases9 )T(s: +ondom #ro$ramme

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Phases of NACP
,edium term #lan 9199."91: 2'+P"1 91991"99: 2'+P"1 9199%"1..%: 2'+P"4 91..7"1.11: ;<b=ective: > To halt and reverse the HIV e#idemic In India? by the end of the #ro=ect.@ 2'+P"/ 91.14"1.18: ;<b=ectives: -educe ne infections by 5. #ercent 91..7 3aseline of 2'+P III:. Provide com#rehensive care and su##ort to all #ersons livin$ ith HIVA'I() and treatment services for all those ho reBuire it.@

C$ P$N%N&S $' NACP (

Prevention
Tar$eted interventions amon$ H-CDs

Amity Institute of Hospital Administration +are& su##ort +a#acity buildin$ )trate$ic and treatment information mana$ement

'-T

7stablishment& su##ort ,onitorin$ and ca#acity stren$thenin$ and evaluation Trainin$ )urveillance

<ther Paediatric interventions9truc*ers& '-T Prison inmates& mi$rants etc.: Inte$rated counsellin$ 0 +entre of testin$ centres e6cellence 3lood safety +ommunication advocacy and social mobili!ation +are and su##ort

,ana$in$ #ro$ramme im#lementation and contacts ,ainstreamin$A #rivate sector #artnershi#s

-esearch

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'nnual sentinel surveillance

(ata on state ise #revalence rates are collected Provides the classification of districts 0 determine the trend of HIV infection in different a$e $rou#. 7stimation of HIV infected #ersons in the country.

Amity Institute of Hospital Administration

Amity Institute of Hospital Administration

National aids prevention and control policy)NAPCP* +,,+

: The 2'P+P 1..1 has been announced ith the aim of bringing AIDS transmission at -ero level by +,,.. : $b/ectives: 0. 1. (. Prevention of further spread of the disease by ma*in$ the #eo#le at lar$e and s#ecially the hi$h"ris* $rou#s a are of its im#lications. To provide an enabling socioeconomic environment so that individuals and families affected ith HIV A 'I() can mana$e the #roblemE and Improve services for the care of Peo#le Livin$ Fith 'I() 9PLF': in times of sic*ness both in hos#itals and at homes throu$h community health care.

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1lood safety programme

$b/ectives
7nsure #rovision of safe 0 Buality blood even to the remote areas in shortest #ossible time. 7nsure reduction in the transfusion associated HIV transmission to less than ..5 #ercent.

Achievements
3lood transfusion councils at state 0 national levels Gonal blood testin$ centres established to #rovide lin*a$e ith other blood ban*s Professional blood donation #rohibited Testin$ of every unit of blood Installation of 3+)H 8unds for moderni!ation of all ma=or blood ban*s at state and district levels.

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Counselling and "I# testing

$b/ectives:
To monitor the trend of HIV infection in a #o#ulation To test blood& or$an or tissue for ensurin$ safety of the reci#ients To identify an individual ith HIV infection

#oluntary counselling and testing)#C&*:

It is a non coercive& confidential 0 an effective a##roach that #rovides information education and communication to motivate behaviour chan$e in HIV #ositive individual

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S&D control programme

Sura2sha Clinic:
2'+< throu$h its net or* of 948 desi$nated )TIA-TI clinics 9situated at $overnment health care facilities at district level and above: is providing free standardi-ed S&I3!&I services. These clinics have been branded as 4Sura2sha Clinics5 and #rovide se6ual 0 re#roductive health services. Standardi-ed training to the medical and #aramedical #ersonnel based on syndromic case mana$ement a##roach is bein$ #rovided and counseling services from trained counsellors are made available at these clinics. +olour coded syndromic dru$ *its and -P- test *its are bein$ centrally #rocured and su##lied to these clinics.

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"I# Surveillance
$b/ectives
To identify trends of sero#ositivity in both the hi$h as ell as lo ris* $rou#s To identify the $eo$ra#hical s#read and ma=or modes of HIV.

1ehavioural surveillance
$b/ectives:
To assess the chan$in$ #attern of behaviour in different ris* $rou#s of #o#ulation.

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&argeted interventions
$b/ectives:
To reduce the transmission of HIV amon$st most vulnerable #o#ulation )uch as: se6 or*ers& homose6ual men& street children& mi$rant labourers.

School AIDS education programme

$b/ectives:
8ocuses to ards student youth to raise a areness level and develo# a safe and res#onsible lifestyle.

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Information6 education6 communication 7 social mobili-ation

$b/ectives:
To raise a8areness& im#rove *no led$e 0 understandin$ amon$ the $eneral #ublic. To promote desirable #ractice To mobili-e all sectors of society to inte$rate messa$es 0 #ro$ramme on 'I() into their e6istin$ activities. To create a su##ortive environment for the care 0 rehabilitation of #ersons ith HIVA'I()

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'amily health a8areness campaign)'"AC*

$b/ectives:
To raise the a areness levels in the slum areas. To ma*e #eo#le a are of the services under #ublic sector for mana$ement of -TIA)TI To facilitate early detection 0 #rom#t treatment of -TIA)TI To strengthen the ca#acity of medical 0 #aramedical #rofessionals To use safe blood from licensed blood ban*s To be a are of P+T

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9in2 8or2er scheme

8ormulated for the rural areas of hi$hly vulnerable districts.

$b/ectives:
+a#acitatin$ the rural community 7Bui##in$ them ith HIV related *no led$e to combat the e#idemic

'nti"-etroviral treatment 9'-T:

Provision of anti -etro"viral treatment at $overnment hos#itals& free of cost& for si6 hi$h #revalence states

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Integrated counselling and testing centres )IC&Cs*

7stablished at medical colle$es& district hos#itals& sub district level hos#itals and community health centres

Prevention of parent to child transmission )PP&C&*

+ounsellin$ 0 testin$ of #re$nant omen& (etection of #ositive #re$nant omen 'dministration of #ro#hylactic Nevirapine to the #ositive #re$nant omen 0 the infants to #revent PPT+T

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"I# and &1

-2T+P and 2'+< have devised a =oint action #lan for T3"HIV co"ordination. $b/ectives: -educe T3"associated morbidity and mortality in PLFH' 7nsure o#timum syner$y bet een the t o national #ro$rammes for effective #revention and control of the disease.

Strategic Information

anagement :nit )SI :*

: )I,H assists 2'+P in trac2ing the epidemic and the effectiveness of the response and hel# assess ho ell 2'+<& )'+) and all #artner or$ani!ations are fulfillin$ their commitment to meet a$reed ob=ectives. : 2'+P envisa$es a robust )trate$ic Information ,ana$ement )ystem 9)I,): hich focuses on #ro$ramme monitorin$& evaluation and surveillance& and *no led$e $atherin$.

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Post e;posure prophyla;is for health care 8or2ers

'nti"retroviral dru$s in combination of 1"4 dru$s have sho n to be #ro#hylactic hen $iven 8ithin + hours of e6#osure. (ru$s #rovided for the health care or*ers in the hos#itals are free of cost.

National aids telephone helpline

8or access to information and counsellin$ +om#uterised / di$it number: 0,<.

Amity Institute of Hospital Administration

Amity Institute of Hospital Administration

Key Achievements
Promotion of voluntary blood donation has enabled reducin$ transmission of HIV infection throu$h contaminated blood from about %..7I 91999:& /.%1I 91..4:& 1..7I 91..5:& 1.9%I 91..%: to 1.87I 91..7:. The number of inte$rated counsellin$ and testin$ centres increased from 981 in 1../& 1/7% in 1..5& /.17 in 1..%& /5%7 in 1..7 and /817 in 1..8 9till )e#tember& 1..8:.The number of #ersons tested in these centres has increased from 17.5 la*h in 1../ to 47.9 la*hs in 1..8".9 9'u$ust& 1..8:. In the year 1..7& a total of 4.1 million #re$nant omen accessed PPT+T services at I+T+s across the country of hich 18//9 #re$nant omen ere dia$nosed to be HIV Jve. <f these 11/%. 9%1I: #re$nant omen and the infants born to them received #ro#hylactic sin$le dose 2evira#ine to #revent #arent to child transmission of HIV.

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The number of )TI clinics bein$ su##orted by 2'+< has increased from 815 in 1..5 to 895 in 1..8. The re#orted number of #atients treated for )TI in 1..5 as 1%.7 la*h& in 1..%& 1..1 la*h and in 1..7& it has increased to 15.9 la*h. 's of )e#tember 1..8& 5&%1&981 #atients have been re$istered at '-T centers and 1&77&8.8 clinically eli$ible #atients are receivin$ free '-T in Covt. 0 inter"sectoral health sector. This is achieved throu$h 179 '-T centers across 41 states. Total 159 +ommunity +are +enters are established across country of #rovidin$ +are 0 )u##ort )ervices to PLH'Ks. The Tar$eted Intervention 9TI: #ro=ects aim to interru#t HIV transmission amon$ hi$hly vulnerable #o#ulations. )uch #o#ulation $rou#s include " commercial se6 or*ers& in=ectin$ dru$ users& men ho have se6 ith men& truc*ers and mi$rant or*ers. 's on date& 1141 Tar$eted Interventions are o#erational in various states and HTs in the country.

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