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With the spread of AIDS from one country to another it became necessary to initiate a national control programme. The Government of India in 1985 constituted a task force to look into this matter. It began by pilot screening programme of high-risk population. National AIDS Control Programme was launched in 1987. In the year 1992, the Ministry of Health and Family Welfare set up a National AIDS Control Organisation as a separate wing to implement and closely monitor the various components of the programme. The Government of India launched a 5 year HIV/AIDS Control Project from September 1992 to September 1997 as 100 percent centrally sponsored project for all States/UTs. The project was later on extended up to March 1999.
The national strategy has the following important components:
1. Establishment of surveillance centres to cover the whole country
2. Identification of high risk groups and their screening
3. Issuing specific guidelines for management of detected cases and their follow-up
4. Formulating guidelines for blood banks, blood product manufacturers, blood donors, and dialysis units
5. Information, education and communication activities by involving mass media
6. Research and reduction of personal and social impact of the disease
7. Control of sexually transmitted diseases and condom programme
1. Establishment of surveillance centres to cover the whole country
2. Identification and screening of high-risk groups
3. Issuing specific guidelines for the management of detected cases and their follow-up
4. Formulating guidelines for blood bank and blood product manufacturers, blood donors, and dialysis units
5. IEC activities by involving mass media and research for the reduction of the personal and social impact of the disease
6. Control of sexually transmitted disease
7. Promotion of condom programme
1. First case of HIV found.
2. AIDS task force set up by ICMR.
3. National AIDS Committee was established.
1. NACP–I was launched
2. National AIDS control organization was setup
1. NACP–II was launched
2. State AIDS Control societies were established.
1. Anti – Retroviral treatment was initiated
2. NACP – III was launched for (2007–2012)
3. NACP –IV was launched for (2012–2017)
The aim of the first phase of the programme was to prevent further transmission of HIV, to decrease morbidity and mortality associated with HIV infection and to minimize the socio-economic impact resulting from HIV infection.
HIV testing is carried out on a voluntary basis with appropriate pre-test and post test counselling. The basis and objectives of testing are to monitor the trend of HIV infection in a population or sub-group; to test blood, organ or tissue for ensuring safety of the recipients; and to identify an individual with HIV infection on voluntary testing basis.
STD control is linked to HIV/AIDS control as behaviour resulting the transmission of STD and HIV are same. HIV is transmitted more easily in the presence of another STD. Hence, early diagnosis and treatment of STD is now recognised as one of the major strategies to control spread of HIV infection. Patients with STD form special group for health education and individual counselling.
Among the probable source of HIV infection in India, heterosexual promiscuity constitute the major route, as almost 75 percent HIV infections occur due to unprotected and multi partner sexual contacts. This type of transmission can be prevented by consistent use of good quality condoms. While the use of condom is easy, making a programme to cover the whole country needs careful planning on certain issues.
These issues are mainly related to following questions:
1. How to sensitize people for using condom not only as a family planning method but also as the best preventive step against HIV and STD ?
2. How to convince the commercial sex workers and their clients about the importance of use of condom as a means for preventing HIV and STD transmission?
3. How to make available low cost and good quality condoms for people at the time and place when they need it most?
The three major areas in which NACO has made significant progress in relation to condom programme are:
1. Quality control of condoms
2. Social marketing of condoms
3. Involvement of NGOs and private voluntary organisations in the programme
The objective of the IEC strategy in the National AIDS control programme are : to raise awareness, improve knowledge and understanding among the general public about AIDS infection and STD, routes of transmission and method of prevention; to promote desirable practice such as avoiding multiple sex partner, use of condom, sterilization of needles/syringes and voluntary blood donation, to mobilise all sectors of society to integrate messages and programme on AIDS into their existing activities; to create a supportive environment for the care and rehabilitation of persons with HIV/AIDS.
In the present day awareness campaign through multimedia has made easy the efforts to reach at larger segment of people. The print media, electronic media, press campaign, interpersonal publicity and field publicity holds the key to success. A massive media campaign was launched by NACO in 1996 through well designed generic materials. Posters, pamphlets, booklets, newspapers, advertisements, film clippings, TV spots, radio spots, wall paintings and cinema slides were prepared in Hindi and all regional languages. IEC programming cannot exist in isolation.
The National AIDS Control Programme Phase II was officially launched on the 15th December 1999. It is being implemented by the National AIDS Control Organization with support from World Bank, USAID and the Department for International Development. The new programme has the features which will amount to a paradigm shift in the nation’s response to prevention and control of HIV/AIDS at all levels.
1. Raising the level of awareness on STD/HIV in rural areas and other vulnerable groups of population
2. Encouraging health seeking behaviour in general population for reproductive tract infections and STD
3. Making people aware about services available in the public health system for the management of RTI/STD
4. Provision of facilities for early detection and prompt treatment
5. Implementing focused IEC strategy.
1. Prevention from HIV infection to high-risk groups and the general population
2. Providing good care, help, and treatment material to HIV/AIDS-affected persons
3. Strengthening the basic infrastructure and human relationship for correct implementation of the ban, care, and treatment programme on all levels for AIDS patients.
4. Strengthening the strategy, information, and management facilities on the national level.
5. Reducing epidemic up to 60% in affected states.
6. In weak states, the prevalence rate reduces up to 40% to control the epidemic.
1. In this main phase, the focus is given on restriction measures and including appropriate health care and treatment.
2. More priority is given to highly infected population areas in which truck drivers, prisoners, refuse, and street children are included.
3. General population areas required the highest restriction services in which treatment of STD, voluntary guidance, training, using of condom included.
4. In this phase, all patients included who required ART and priority is given to providing related drugs on time.
5. Provision made to prevention of HIV infection from mother to child and providing complete treatment services to infected mothers.
6. Increasing the opportunities of nutrition and income to reduce the HIV consequences.
7. Providing psychosocial assistance, outpatient services, referral services, and palliative care services in community health centres.
8. Inhibiting the prevalence of HIV/ AIDS by working together with women groups, youth groups, worker’s associations.
Essential counselling and investigation facilities are provided on ICTCs. It is established at medical colleges, district hospitals, sub-district hospitals, CHC for 24 hours. Further, these services are proposed to increase in primary health centres.
In 2009, total of 5135 ICTCs were established, and about 60.8 lakh patients were investigated. At present more than 8000 ICTCs are established and 200 million people get investigation and guidance facilities on these centres.
1. Prevention of HIV transmission from mother to child: Under this, about 5135 ICTCs centres are providing appropriate counselling and treatment facilities to pregnant women. For HIV-positive women, protective nevirapine (NUP) is administered within 72 hours of delivery.
2. HIV-positive patients have more risk of developing tuberculosis because TB symptoms are firstly seen in HIV patients.
3. Promotion of cross-referral services with NACO and RNTCP for early diagnosis and treatment.
4. HIV test is compulsory for all TB patients under RNTCP.
Following services are provided under this phase:
1. Goal-oriented activities for high-risk groups
2. Needle syringe exchange programme and opioid substitution therapy for IDUs
3. Prevention of interventions for the migrant population at source transit and destination
4. Link worker scheme for HRGs and vulnerable population in rural areas
5. Prevention and control of STI / RTI
6. Blood safety
7. HIV counselling and testing services
8. Prevention of parent-to-child transmission
9. Condom promotion
10. IEC and BCC activities
11. Social mobilization, youth interventions, and adolescence education programme
12. Mainstreaming HIV/ AIDS response
13. Workplace interventions
1. Providing laboratory services for CD4 cells and other investigations.
2. Providing first-line and second-line antiretroviral therapy for children.
3. Providing early diagnosis services for children below 18 months of age.
4. Providing nutritional and psychosocial support through care and support centres.
5. HIV/TB coordination services.
6. Treatment of opportunistic infection.
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