Re: National AIDS Control Programme: A critique. Rejoinder

[Guest guest]

Dear All,

In response to the article " National AIDS Control Programme: A Critique" by Rami Chhabra published in Economic and Political Weekly, January 13-19, 2007, pp 103-108, we would like to raise our concerns.

Ms. Rami Chhabra as a citizen of the largest democratic country has every right to place her prospective and believes, how ever it is unethical and immoral to bury actual figures and facts as it has been observed in her article with specific reference to Sonagachi Project, Kolkata.

In her article she wrote "Sonagachi's own surveys reveal a considerable influx into sex work. A recently survey indicated that among the new recruits, a majority are in their teens or twenties; one-third to half engage in group-sex; 87 per cent got pregnant; 41 percent underwent abortion, 17 per cent three times or more; 50 per cent underwent STD treatment during the previous year; 14 per cent never used condoms; while "always use" condoms indicated 90 per cent of time" which is completely spurious and presented with a malign intention. The base line survey (1992) and all the Point Prevalence Surveys(PPS) conducted in different years (1995, 1998, 2001 & 2005) were carried out in Sonagachi among the sex workers following appropriate sampling strategies with the help of technical advisors from All India Institute of Hygiene & Public Health (AIIH & PH) & National Institute of Cholera & Enteric Diseases (NICED). The reports are available on request. The following table reflects the actual impact of the Intervention project.

Point Prevalence Survey, 2005 (Sample Size 560)[1]

Engaged in Group Sex

Got Pregnant

Underwent abortion

Underwent abortion 3 times of more

VDRL Positivity

(1:8 & above dilution)

Condom Use

Prevalence of HIV

% of SWs

0.5

83.04

35.7

4.11

0.18

86

5.17

The success in controlling the transmission of HIV among sex workers covered under Sonagachi Project has been verified in sentinel surveillance conducted by National AIDS Control Organization (NACO) in different years. By the way till date we haven't done any survey among the new recruits.

We also have succeeded considerably to prevent the entry of minors and unwilling women in sex sector following our innovative self regulatory mechanism (interested person can access our website www.durbar.org to have a comprehensive idea about our efforts and achievement in the arena of Anti Trafficking). The following table shows significant decline in proportion of sex workers < 18 years old in sex work sites where DMSC works

Year *

1992

1995

1998

2001

2005

Sample size surveyed

450

496

513

629

560

Proportion of sexworkers (in years)

22

22

27

28

28

* Data from Sonagachi Project Baseline Survey (1992) and Follow-up Surveys (1995, 1998 and 2001, 2005)

Presently, we are running multiple anti trafficking programmes in collaboration with UNDP-TAHA, Terre des hommes (TDH) & ACTION AID, India.

Sonagachi Project from the very inception has been studied, reviewed and evaluated by different national and international institution and agencies in different times and the project's success in terms of health impact has been clearly delineated in those studies and reports. For example, by World Health Organization (1995), International Family Health Sexual Health Consultancy, UK (1999) and Department for International Development (DFID), UK (2002) carried out independent evaluation studies of the project. These reports speak volumes about the efficiency and efficacy of the approaches and actions articulated in Sonagachi Project. One needs to consult these documents before passing such sleeping comments regarding a project; acclaimed both at national & international level as a model project.

The author must be happy to know that Sonagachi Project has made a paradigm shift in the existing developmental programme which is articulated as "Community Led Structural Intervention (CLSI)", an approach already recognized both nationally and internationally as one of the best ways to address the vulnerability of marginalized communities to HIV/AIDS. In fact for the last few years we have been carrying out different operational researches on community led approaches to health and development in collaboration with Universities, across the globe (UCLA, YALE, HARVARD, CLARK, Manchester etc.)

With regards,

Bharati Dey

Programme Director

DURBAR

[1] The survey was conducted with the support from West Bengal State AIDS Prevention & Control Society & in collaboration with All India Institute of Hygiene & Public Health (AIIH & PH) and National Institute of Cholera & Enteric Diseases (NICED)