Re: Proposed review of NACO

[Guest guest]

Hello to the list readers from Calcutta,

I commend the Minister in the long overdue review of the NACO organisation.

Some of us have been nipping at the heels of the organisation for some time

trying to get it to pay attention to some important players in the solutions

for India.

I just want to flag some issues.

HIV/AIDS is not and should never be seen as a permanent part of the health

strategy of India. Everyone working in this field should be working to make

their jobs redundant. Most of the resources expended by NACO have been

absorbed by the AIDS Industry with an unmeasurable part of the immense

numbers of core's of rupees finding its way to directly benefit infected and

affected communities.

Whoever is charged with the review process must have clear and binding terms

of reference.

These terms of reference will be clearly the most important part of the

review process and debate should commence immediately on a draft of these.

Once an acceptable draft is in place and agreed to then the agency can

implement some reviews, the most important part of which will be to centre

all initiatives into the S.A.C.S. in each State even if they have to be

dragged kicking and screaming into the process of accountability. It is the

only way that the vastly divergent social groupings can be addressed.

The next important feature is to avoid sidelining low prevalence areas on

the grounds that the numbers are small. It can be demonstrated that most of

the emerging higher prevalence areas were once low prevalence areas that

were low prevalence by accident and could have been continued as low

prevalence by design.

I remember a Politician in Tamil Nadu stating at an HIV/AIDS meeting in her

electorate that her aim was to see India AIDS free by 2010. I hastened to

assure her that it would never come to pass because we were hell bent on

teaching positive people to be living well with the infections and they

would not die on cue to satsfy such a prediction. Instead I suggested that

we see India with no new infections by 2010 because that was an aim that

could be achieved, but to do so would require a massive shift in educational

policies around sexual health and practices and any elected politician who

championed such a course of action would surely be unseated at the next

election by fundamentalist interests.

A cure is not on the horizon, a vaccine has more problems to solve that have

been addressed therefore a properly targeted prevention program is

imperative in age appropriate settings in homes, schools, churches, temples

and communities.

No one should die of HIV since 1996 and no one should become infected

because we know precisely how most infection occurs and what to do to stop

it happening. The problem is the community doesn't know it and that is where

the problems lie. We need targeted interventions and we should stop

immediately targetting risk groups. It is not a group that is at risk it is

flawed behaviour and judges, politicians, lawyers and accountants are just

as liable to engage in risk behaviours as villagers, sex workers, housewives

and students.

One very important part of this process is some fine tuning of the VCT

processes. As a numerator of infected persons, it excells. As an imparter of

confidence, education and hope it fails miserably.

May the Health Minister see this as one of the most imperative parts of any

review process because without appropriate terms of reference we will simply

dredge up more statistics to prove that what we have always done is the best

possible and will be enough.

Geoffrey

E-mail: <gheaviside@...>

Geoff Heaviside

Convenor - Brimbank Community Initiatives Inc

Secretary - International Centre for Health Equity Inc

Member - Australasian Society for HIV Medicine Inc

P.O. Box 606 Sunshine 3020

. Australia.

Ph: 0418 328 278

Ph/Fax : (61 3) 9449 1856

or in India

Mr Geoff Heaviside

Mobile : (91) 9840 097 178 (Only when in India)

" Concern for what is right causes us to do our best - Knowledge of what is

best inspires us to do what is right. "