 "A girl light candles during an AIDS awareness campaign. Photo: PTI")
As India observes World AIDS Day on Tuesday, all is not well. Changes in the way money is transferred to state AIDS control societies (SACSs) and lack of budgetary support may result in a resurgence of the dreaded disease.
The budgetary allocation for the Department of AIDS Control stood at Rs 1,397.00 crore in 2015-16, nearly a 22 per cent reduction from the allocation of Rs 1,785.00 crore in 2014-15. The National AIDS Control Programme (NACP), which had set ambitious goals for its fourth phase, could very well be jeopardised as a result and that would not bode well for a country which had nearly 2.09 million people living with HIV/AIDS according to 2011 estimates.
“The request for budget for 2015-16 for the AIDS control programme was around Rs 1,800 crore. There was an almost 22 per cent slash from the actual requirement for the programme,” says Nochiketa Mohanty, country programme manager of the AIDS Healthcare Foundation.
Commenting on the reasons behind the slash in funding, Mohanty says, “States often do not complete their activities on time because they do not receive the required money on time. Every year, by the time the states receive the required money, it is already the end of the first or second quarter and as a result they often scramble to finish the activities they had listed out in the last quarter. As a result they are not able to utilise their budgets completely and therefore cannot show the sort of expenditure that would justify an increase or at least discourage a slashing in the next year’s budget...it is like a chain reaction.”
The National AIDS Control Organisation (NACO) had been spearheading the NCAP earlier; however, in August last year, the departmental status of the AIDS programme was revoked by the government. “NACO used to work like an autonomous body headed by a director general and secretary. Now NACO only has operational powers while most of its financial powers stand reduced. Today the body is headed by an officer of additional secretary rank,” says Mohanty. Additionally, the government’s move in early 2014 to change the process by which the Centre distributes funds for AIDS control to the states has created new problems. Describing the situation, Mohanty says: “Earlier the funds used to flow from the finance ministry to NACO and then directly to SACSs. Now, the funds first flow to the state treasuries instead of the SACSs and then the treasuries release these funds to the SACSs. Now the treasuries decide whether HIV is a priority for them or not. That is what is causing problems and as a result states like Maharashtra have not had the required money for things like the targeted intervention project for the past few months.”
Dr Meguosielie Kire, project director of the Nagaland State AIDS Control Society, says, “Since the funds now go straight to the state treasury instead of the SACS, we don’t receive the funds on time. Many of our activities, which are fund-oriented, like orientation and training are curtailed.”
According to HIV Sentinel Surveillance (HSS) 2012-2013, the highest prevalence of HIV among Antenatal Clinic (ANC) attendees, considered a proxy for prevalence among the general population, was recorded in Nagaland at 0.88 per cent.
According to HIV Sentinel Surveillance (HSS) 2012-2013, the highest prevalence of HIV among Antenatal Clinic (ANC) attendees, considered a proxy for prevalence among the general population, was recorded in Nagaland at 0.88 per cent.
With the SACSs having to wait on the state treasuries to release the funds, their staff often go without salaries for up to three-four months. “Our intervention centres are manned by contractual staff and the new method of transfer of funds has meant that these workers may not get their salaries for months,” says Kire. “However, our staff are so committed that they continued doing their duties without the pay. That, at least, was an encouraging thing,” he adds.
“Personally, we should go back to the old system where NACO used to transfer the funds directly to the SACSs,” Kire concludes.
“There have been some delays in release of funds. In the beginning there was a delay of 69 days between request and release of funds. However, the time taken for releasing funds has come down now,” says S G Raveendra, project director of Karnataka State AIDS Prevention Society. “Release of funds under the new system cannot be as fast as under NACO directly releasing funds to the SACSs,” he adds.
Raveendra concedes that the delays have impacted the payment of salaries to the society's contractual staff and the outreach workers of various NGOs which receive funds from the prevention society. However, he clarifies that the effect is not severe on the contractual workers of the society itself since they have surety of receiving their salaries despite any delay. He believes that the current system has its merits as it brings in “financial accountability”.
According to HSS 2012-2013, HIV prevalence among ANC clinic attendees in Karnataka stood at 0.53 per cent, the fifth highest of all states.
“This year particularly there will be some ups and downs since the NITI Aayog did a review of the funding pattern of various centrally sponsored schemes,” says Raveendra.
The budgetary support for Karnataka's prevention society has also seen a slide. “Already we have seen a funding cut. We had given a budget estimate of Rs 117 crore for 2015-16 but only Rs 77 crore was allocated. A proposal was sent from the Karnataka SACS to NACO for a budget for three years up to 2016-17. We were told that this year's budget will be 80 per cent of the previous year's. Our budget was Rs 96 crore last year; in effect it works out to nearly a 35 per cent cut from our budget estimate for the current financial year,” says Raveendra.
“For paying contractual employees alone I require Rs 40 crore however under the current budget I only have Rs 34 crore for their salaries," he says. According to Raveendra the shortfall will be addressed in the revised budget estimate.
