Hyderabad: More than a dozen key representatives of the State, from the marginalized communities like sex workers and homosexuals, besides people living with HIV-AIDS would participate in a two-day Southern Regional Consultation in Bangalore on June 12 and 13 to shape the country’s response to HIV for the next five years.
Besides marginalized communities like women in sex work, men having sex with men (MSM) and people living with HIV/AIDS, Community-Based Organisations (CBOs) and Civil Society Organisations (CSOs) will facilitate the formulation of National AIDS Control Programme’s fourth five-year plan, an emerging document that will seal the fate of HIV program in India for the next five years.
Chennai would host the Regional Consultation (South) for Injecting Drug Users (IDUs) while the other regional consultations are being held in Pune for West, Kolkata for East, Delhi for North and Guwahati for North East.
National AIDS Control Organisation (NACO) has initiated the process of designing NACP IV, constituted Working Groups for different thematic areas like Access to Basic Services, Care, Support and Treatment and Targeted Interventions for groups affected by HIV/AIDS.
A national medical expert who was involved in the HIV planning for many years, Chennai-based Dr Sunderaraman said, “The Targetted Interventions (TIs) should holistically address the individual at risk and not just the risk behaviour of the individual. That means, the National Plan should go beyond prevention strategies like distribution of condoms and providing treatment for Sexually Transmitted Infections (STI) and address individual concerns like schooling for children of sex workers, providing livelihood to Injecting Drug Users (IDU), similar to providing minimum employment to rural masses under National Rural Employment Guarantee Act (NREGA).”
Elango Ramachandar, one of the founders of Indian Network of People Living with HIV (INP+) said, “There are a whole lot of issues being faced by people living with HIV and stressed on the livelihood issues of positive people, especially children. Many of them are below poverty-line. Once they are tested HIV positive, society rejects them and they end up as paupers despite having property. So it is very essential for the government to look into schemes that provide livelihood to PLHA.”
A state-level CBO of FSW Chaitanya Mahila Mandali’s President Jayamma, Hyderabad says, “NACP III did initiate a few measures towards empowering the communities and also linking the CBOs to care, support and treatment mechanism. A beginning, no doubt, is made but there remain certain critical structural and programmatic barriers that are preventing the community in accessing services. Not having a single-window mechanism for testing and treatment process is one aspect that needs to be corrected as it helps the communities; the female sex workers in particular, reduce dropouts among ART users. Mandatory requirements like producing ration cards as a proof of identity have been a hindrance for the FSW community in accessing ART services.”
“The programme needs to give priority to the FSW by making them part of the core committees which will inculcate a sense of ownership of the programme among the community members and help reach the programme goal of reaching out to the last person in the affected groups.”
“Community-led efforts yield desired results only when the community is equipped with requisite skills and knowledge in managing the programme. Hence, capacity building especially on community empowerment and project management is highly essential at all levels.”
Another community representative, Sumitra from Tirupati, Chittoor district, says, “A lot was said about mainstreaming the communities but not enough priority was accorded to advocacy – a key component in mainstreaming. As our experience with the Core Community Advocacy Groups has shown us, sustained advocacy at various levels empowers the community to mainstream itself. Advocacy should be treated as one of the core components in the HIV prevention programme.
Trained and effective core advocacy groups in a few districts of Andhra Pradesh helped the communities to avail prevention, care and support services as well as social entitlements in the last few years. This needs to be taken forward on a broad-basis as they also play a key role in crisis management besides addressing stigma and discrimination-related incidents.
“Close coordination needs to be established among the CBOs, PLHA networks and gross-root level working groups like Aasha volunteers, Link Workers, Anganwadi workers to enhance HIV prevention efforts. Also, FSW and MSM representatives should be made part of the District Health Coordination Committees for effective implementation of the programme.”
A state-level CBO for MSM and TG Suraksha Society, Hyderabad President Krishna said, “Reducing stigma and discrimination against the MSM and TG is one of the biggest challenges the programme is facing. Discrimination against these communities, at healthcare settings in particular is keeping them away from HIV prevention, care and support services, including ART centres. Medical and support staff needs to be sensitized on a war-footing as primarily their misdemeanors have ensured that the programme is out of bounds for the MSM and TG.”
AP State PLHA network Telugu Network of Positive People (TNP+) President Ramesh opined that the NACP IV has to give more priority to provide care and support to all PLHA.
“Presently there is only one care and support centre in each district which is not able to meet the requirements. There are about four lakh PLHA in Andhra Pradesh as per data available with AP State AIDS Control Society which calls for more centres. Priority should be given for child ART. Besides, the issues of women PLHA and HIV/AIDS infected and affected children need to be addressed on a priority basis.”
Chennai would host the regional consultation (south) for Injecting Drug Users (Date yet to be confirmed). The other regional consultations are being held in Pune for West on 13-14 June, Kolkota for East on 13-14 June, Delhi for North on 14-15 June and Guwahati for North East conducted on 9 June.(INN)