Concerns about ARV treatment plan: Request for an Interactive Session

[Guest guest]

Hi

Please find below a copy of the letter handed over to Dr. Alka Gogate , Project

Director, Mumbai Districts AIDS Control Society (MDACS) , regarding an

interatcive session on the Implementation of ARV Treatment Plan. Letter is

written by the Forum for HIV/AIDS, Mumbai . The Interactive Session will be held

on 16th April 2 pm.

31st March 2004

To

Dr. Alka Gogate

Project Director

Mumbai Districts AIDS Control Society (MDACS)

Acworth Complex, Wadala, Mumbai

Dear Dr. Gogate

Sub: (Request for an Interactive Session on the Implementation of ARV Treatment

Plan)

As you know the Forum for HIV/AIDS in Mumbai is a network of Civil Society,

NGOs, Community Organisations and Individuals working in the field of HIV/AIDS.

At the outset we would like to congratulate you and your colleagues for the hard

work being done to make the free ARV treatment plan a reality in Mumbai, by 1st

April 2004.

The Forum, at its last meeting, had the opportunity to discuss the ART programme

implementation. At this meeting the 'Programme Implementation Guidelines for a

Phased Scale up of Access to Antiretroviral Therapy (ART) for People Living with

HIV/AIDS (PLHA)' was discussed at length. Although we gladly welcome the

decision of the Government to finally provide free ART, we have a range of

concerns about how such a plan will be operationalised. As you are well aware,

any program for mass provision of ART is complex and involves the consideration

of a range of issues including ability to comply with and adhere to treatment,

human rights such as consent to treatment and confidentiality, sustained supply

of drugs and the impact of inclusion/ exclusion of people from the program,

management of side effects, counselling, nutritional support, redressal

mechanism, role of stake holders, sustainability of the programme etc. We are

concerned that many of these issues are either not addressed or are minimally

recognised as priorities in the policy document.

We are happy to find that the document recognises the role of community

participation. As you know, the guidelines emphasise the importance of involving

and mobilising stakeholders and requires the various State AIDS Control

Societies to facilitate such involvement through proper consultation. On our

part, we are happy to offer our full co-operation in such a process. At the same

time we feel that such involvement should start at the outset, rather than as an

additional feature of the ART programme. We feel that it is only with such

participation a sustainable and viable ART programme can be put in place.

Unfortunately, the policy document is silent about the details of micro level

planning for such stakeholders' participation.

In this context, we would like to know the manner in which MDACS visualises

stakeholders' participation. We would also like to discuss how we may work

together to enable effective consultation. We therefore propose to hold an

interactive session with you and your team at the earliest. We hope that such a

meeting would lead to a concrete action plan for the involvement of stakeholders

in the implementation of the programme in Mumbai and Maharashtra. We hope to

find clarity on the issues and concerns. Some of these issues and concerns are

mentioned below.

a. What would be the estimated cost for the implementation of the programme in

Mumbai and Maharashtra?

b. What are the break ups of the resource allocation viz. capacity building,

infrastructure, salary, drug procurement etc. for the plan?

c. What is the mechanism for estimation of ARV drugs and its distribution?

d. What is the expected number of beneficiaries in the plan for the first year

(2004-05)?

e. Are there any guidelines for the inclusion and exclusion of people in the

programme? If so what are they?

f. What is the plan of action for the preparedness of the communities?

g. What would be the envisaged role for stakeholders in the implementation of

the programme?

Hoping to hear from you soon in this regard at the earliest.

With warm regards

Secretariat of Forum for HIV/AIDS

CC: Union Minister of Health and Family Welfare

Minister of Health (Maharashtra)

Secretary, Ministry of Health and Family Welfare

Secretary, Health (Maharashtra)

Director of Health Services

Director, NACO

Director, AVERT

UNAIDS, India

WHO, Director General

WHO 3 by 5 Incharge

lawyers/ Forum for HIV/AIDS, Mumbai

E-mail:<aidslaw@...>