A rapid assessment of the progress of ART Scale up in India.

[Guest guest]

A rapid assessment of the progress of ART Scale up in India.

INP+ Call for honorary advisory board members.

As part of a global – International Treatment Preparedness Coalition

(ITPC) assessment of the progress of ART Treatment, Indian Net work

of People living with HIV & AIDS (INP+) is seeking research partners

and honorary project advisors for it's efforts to carry out a rapid

assessment of the progress of the ART scale up in India.

Recently, the political leadership and commitment has shifted

significantly in favour of providing access to anti-retroviral

treatment (ART) for people living with HIV/AIDS. Treatment is now

perceived as a critical component of a comprehensive program to

combat HIV/AIDS, along with prevention and the improvement of health

care infrastructure for the delivery and monitoring of care and

support.(NACO 2004). On World AIDS Day 2003, WHO and UNAIDS set an

ambitious target that 3 million people living with HIV/AIDS in

developing and transitional countries would be receiving

antiretroviral therapy by 2005 and the progress so far. (WHO 2005)

In response to the call to action " at the UN General Assembly

Special Session on HIV/AIDS (June 2001), which pushed forward a new

global consensus on the need for ART, the government of India

through NACO proposed a paradigm shift in the National AIDS Control

Programme and announced a strong policy cum programme commitment for

provisioning anti-retroviral treatment to 1,00,000 people living

with HIV/AIDS, free of cost in six high prevalence states, with

implementation starting on 1st April, 2004. In Phase I of

implementation, the sub-groups among the PLHAs being targeted on

priority are: sero-positive mothers who have participated in the

PPTCT programme, seropositive children below the age of 15 years;

and people with AIDS who seek treatment in government hospitals

(NACO 2004).

In June 2004, the Global Fund on AIDS, TB and Malaria awarded a

financial grant of US $ 165 million to provide antiretroviral

treatment in the public sector and through public-private

partnerships for 1,37,000 people living with AIDS over a five year

period. Beginning in April 2004, procurement of ART drugs and

medicines has been made by WHO. Government has initiated steps to

ensure that during 2004-05 drugs and medicines for nearly 30,000

people living with AIDS would be procured and disbursed to the 25

hospitals identified. NACO anticipate that they will meet the

target of providing ART to 25000 patients during year 2004 (NACO

2004).

According to Dr S.Y. Quarashi, Director General of NACO , " We are

providing free ARTs to about 6,800 people in 25 centres. Our target

is to reach out to one lakh people by 2007. We hope to start giving

free treatment in another 100 centres this year. " He further said

that treatment from private sector would be at least three-four

times this number. NACO is in the process of collating this data.

In addition to the NACO initiative, some of the state governments

also began state level ART schemes. Charitable foundations and

several NGOs also providing assistance to provide ART. It appears

that many people living with HIV/AIDS in India are paying for their

own ARV treatment.

India may have the second largest number of HIV/AIDS patients in the

world, but overall, access to anti-retroviral (ARV) drugs is still

very limited. This, despite the fact that Indian generic companies

such as Ranbaxy Laboratories, Cipla Ltd and Hetero are globally

recognised for providing cheap and quality ARVs. Commentators like

Human Rights Watch have further expressed concerns about lack of

access to ART for Children.

The objectives of the rapid assessment of the progress of ART Scale

up in India is to assess HIV/AIDS treatment scale up efforts in

India, Identify the major barriers to wider treatment delivery, and

make constructive, highly credible recommendations to multilateral

and bilateral agencies and national governments. The primary goal is

to identify where improvement is needed and how it can be

accomplished.

This assessment will provide a scorecard and supporting analysis

that evaluate the work of major actors in AIDS treatment scale up.

The Report will use " a scorecard format " in which " good work "

and " needed improvements " are identified in bullet points for each

major player on a simple two-column report card.

Organizations to be evaluated may include: WHO, UNAIDS, The Global

Fund, PEPFAR (applicable), major National and International NGOs,

community based organizations providing ART services, and the

national and state governments (NACO & SACS). Data for this study

will be collected from multiple sources through multiple data

collection tools. The following stakeholders will be interviewed. A

separate interview guide will be used to collect data from each

stakeholder.

Among other benefits, this assessment is expected to give us a

better understanding on the structure of ART Scale up in India,

location of ART sites, list of ART scale up partners, extent and

nature of partnership for ART (Technical, Collaborative, networking,

financial and political), estimated number of people receiving ART

in each states, estimated number of children receiving ART in each

states, estimated number of orphan children receiving ART in each

states, estimated number of women receiving ARV in each states and

number of ARV identity cards distributed.

Considering the urgency of such an assessment on behalf of ITPC the

INP+ has assembled a small research team to develop research

proposal and a detailed research protocol. The proposed research

project will be guided by an honorary advisory committee nominated

from the key stakeholders of HIV/AIDS related issues in India.

In this context, INP+ is inviting _expression of interest from

interested individuals and agencies to act as honorary advisory

committee members of this project.

Please contact for further information and _expression of interest.

K.K. Abraham, President of INP+ (email- kkabraham@...) or

Joe (E-mail- joe_thomas123@...)