Re:Proposed review of NACO

[Guest guest]

Three messages are combined into one (Moderator)

1) Issues to be considered in NACO review

Geoffrey

2) I sincerely hope this would not be another exercise with some meaning.

Ch.Anand

3) This is excellent

Ruth Kattumuri

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1) Issues to be considered in NACO review

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@...>

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2) I sincerely hope this would not be another exercise with some meaning.

Ch.Anand

Dear FORUM,

I sincerely hope this would not be another exercise with some meaning.

The move is well appreciated and timely when much has already gone down the

drain. Big claims by NACO has become some kind of a routine advertisement while

the reality says something else.

It was a pain when message like the infection rate among the IDU in Manipur has

been controled...wooh!!! (15 IAC-Bangkok). This info. Is based on what ? Has any

study been done ? What is the kind of surveillance system in place ? How do NACO

monitor and evaluate their programs ? Well, many more issues needs to be put on

the table. But to start with we all should be expecting a clean move with this

initiative from the respected health minister

Thank you.

Ch.Anand

E-mail: <chanand43@...>

_________________

3) This is excellent

Ruth Kattumuri

This is excellent. Regular reviews are essential to monitor and improve

performance.

This is a way forward indeed. Congratulations to Dr Ramadoss' initiative in this

process.

Ruth Kattumuri

London School of Economics

E-mail: <r_katts@...