Re: Invitation of NACO for Partnership

[Guest guest]

Dear Forum,

I fully agree with Geoff Heaviside who gave a nice session raising varied issues

regarding invitation of NACO for partnership to combat HIV/AIDS.

First of all distribution of resources , basically economic resources, should be

need based and demand oriented. State having more threats of HIV infection,

more prevalence of HIV or more PLWHA need more resources. Also it is important

to look into performance indicators. It should not be the no of

cases detected or counselled. We need to develop a check list of suitable

performance indicators. Money coming to NACO from different sources in the name

of potential danger of future HIV burden in India, should be appropriately

distributed and equitably spent.

About the invitation of partenrship, it should not be a whimsical process, like

who ever wants, they can come and join. It may lead to placement of a great job

in the hands of an irresponsible institution. We should think to develop and

identify, who are potential and suitable candidates to bear the roles of

partners? I donot know, what may be the selection criteria. But there should be

no doubt that it should only be handled by a sensible and genuine instituiton

whose eligibility is not just who had submitted 3 years of return, or annual

reports and having a 7 members in their organization.

There is also concern about competing prioritiesbetween managing O.I and

prescribing ART with overenthusiasism. If you consdier DALY, QUALY, it is not

always true that only ART is the solution. Country with poor drug monitoring

facilities, few people at hand to prescribe ART effectively are issues of

concers. It is better not to prescribe ART than improper ART- thinking of

potential resistance issue.

I congratulate Mr Geoff for his visionary opinion mentioning the issue of

providing portable drinking water and nutrition rather than inappropraite ART.

While stigma is a cross cultural issue, having huge variations in perceptions

and its impacts on the societies in relation to HIV, it is manadatory to put

up a Stigma prevetion policy which may be culturally sensitive. Ofcourse there

may not ne a unique policy for the entire nation. Partership may be a solution

towards it.

Fianancing in HIV, monitoring for ART, competing priority between ART and

control of O.I.,stigma prevention policy, making strategies sustainable are

in my opinion key issues . How , where and in what role a partner can bear is

important. Let us think.

Regards,

Dr. Arup

E-mail: <arup_dr@...>