India's response to HIV/AIDS - in UNAIDS website

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National Response Brief

INDIA

Profile

India, with 1.027 billion people, 28% of whom live in urban areas, has a

HIV/AIDS infection rate estimated at 0.7% of the adult population. In 2001, it

is estimated that 3.97 million adults were infected with HIV. With the current

disease burden, HIV will emerge as the largest cause of adult mortality this

decade, together with an additional 1 million TB cases. The second phase of the

National AIDS Control Plan has been established through NACO & State AIDS

Control Societies in every state, involving over 600 NGOs in targeted

interventions.

India is one of the few countries that initiated HIV-prevention activities in

the very early stages of the epidemic and the country has maintained its

commitment to prevention efforts. The government is a Federal Republic with 35

states and union territories. The Indian Prime Minister announced in August 2001

that the government would attach topmost priority to HIV as a national issue.

However, due to the vast size of the country, there are many challenges involved

in expanding the high-level commitment to all states and to the grass-roots

level, involving ministries other than health, and scaling up interventions to

meet the projected needs for prevention and care.

Indian demographics reveal a life expectancy of 63 years, a fertility rate of

3.1% & a literacy rate of 65% (75.85% for males, 54.16% for females).

Thirty-five per cent of the population live below the poverty line and the

country ranks 115th out of 162 countries on the HD

Context

Burden Adult prevalence: 15-49-years-old

0.7% (2001) with approximately 3.97 million adult HIV infections, the

second-highest in the world.

Trends and prospects

Despite a strong intervention strategy, the number of infections is still on

increase in the high prevalence States due to inadequate coverage of high risk

population. some States still have low HIV prevalence but they are vulnerable

because of migration patterns.

GNP per capita (US$)

US$440

(1999)

Financial Gap

US$200 million (at the current financial absorption capacity in the next five

years)

National Strategic Framework

Status

SP for 1999-04 completed and being implemented. Annual review of strategy by UN

agencies, govt and bilateral agencies with civil society.

Priority action areas

Targeted nationwide intervention for vulnerable communities. Prevention

intervention for the general community, incl.blood safety, w/100% coverage.

HIV/AIDS care w/PMTCT. Institutional strengthening, incl. surveillance.

Inter-sectoral collaboration.

Multisectoral involvement/key partnerships

The current programme involves health, education, labour, railways, heavy

industry (e.g. steel), the military, youth, etc. The Planning Commission in its

next five-year plan is actively considering policies and programmes on HIV in

main ministries.

Implementation plan

Status

Technically sound and appraised by external agency. National as well as

state-specific five-year operational plans have been drawn up with annual review

and revision mechanisms. Resource gap hinders full-scale implementation of the

plan.

Costed

Current available resources at US$60 million per year. Costed. Additional

resource requirement is US$200 million over 5 years at current financial

absorption capacity.

Nationwide

A nation-wide programme has been planned with universal coverage as a target for

both geographic and population subgroups.

M & E component

Yes

Nationwide behavioural surveillance surveys, HIV sentinel surveillance

operational.

Political commitment

National financial support

Approx. US$320 million for 5-yr plan comes from the gov't. by Int'l. Dev. Agency

credit (US$191 million) towards existing infrastructure costs. Provision for

further support across sectors has been requested from Planning Commission in

its next 5-yr plan

National policies

National HIV policy is in place. This adheres to international standards of

testing, HIV in the workplace, care and support practices and human rights.

High-Level government support

Prime Minister announced HIV as the greatest public health issue in 1999, and

again in August 2001. Prime Minister himself reviews the programme with the

Chief Ministers (state-level) and convened India Business Council meeting.

Institutional status

Coordination mechanisms

Three mechanisms:

- National AIDS Cmte chaired by the Health Minister.

- National-level Coordination Cmte on TB, Malaria & HIV chaired by the Health

Secretary.

- UN TG w/govt & bilateral agency membership

Management capacity

Federal level: Nat'l AIDS Control Org. for funding, guidelines & monitoring &

evaluation

State level: State AIDS Control Societies for decentralized mgt & rapid fund

flow.

11 Technical Resource Groups

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