Number of HIV infections in India will increase if the National AIDS Control Organisation (NACO) is closed and its activities merged with the National Rural Health Mission (NRHM), activists and experts said Monday.
Sixty participants representing communities of drug users, male-to-female transgenders, men who have sex with men (MSM), female sex workers (FSWs) and people living with HIV (PLHIV) from West Bengal, Jharkhand and Bihar gathered at the "AIDS Momentum 2022' consultative meet here.
Experts argued that in 2003 the BJP-led NDA-1 government had taken the monumental step to make anti-retroviral drugs free for patients in six states when Sushma Swaraj was the health minister.
In its second stint it has taken a "step back" mid-Aug with the current decision of "merger", they said adding that this would "compromise" the aids control programme across India.
According to Sonal Mehta, of HIV/AIDS Alliance India, the plan to "restructure" NACO, a division of the health ministry which had autonomy over the programmes across India, is not "transparent enough" and needs clarifications.
NACO was constituted to implement the first National Aids Control Programme in 1992 which is in its fourth phase now (NACP-4).
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"In 1999, the BJP was courageous enough to say we must fight HIV. The step to introduce the drugs was the most successful one... it seems that information has not gone down. The BJP now must stand up and back the progress that we have made so far... it must rise to the occasion," Mehta said.
"This (merger) will be a step back for us in terms of prevention," she said.
This is the third in the series of seven pan-Indian consultations spearheaded by the NGO HIV/AIDS Alliance India. Inputs gathered from these meetings will be used to prepare a memorandum to be submitted to Union Health Minister Harsh Vadhan this month.
Bharati Dey, secretary, Durbar Mahila Samanwaya Committee (DMSC), the largest collective of sex workers in Bengal, said the sex workers feared the discontinuation of the NACPs would impact preventive measures within the community and further marginalise them.
"We conducted a survey last week among the sex workers in Sonagachi (red light district in north Kolkata). Ninety-six percent of them said if the doctors' clinic set up for sex workers were shut down because of the merger, then they would not seek help from normal clinics or state-run hospitals as they feared it would only stigmatise them further," Dey told said.
India has over 2.5 million HIV positive people, the third largest globally. In the past 10 years, the new HIV infections annually have come down by 50 percent. Right now, the disease incidence is 2.5 percent but new infections need to go down by 90 percent to have significant impact.
"In light of the rise in infections in several pockets in India and persistently high levels of discrimination, communities of sex workers, drug users, transgenders, men who have sex with men and people living with HIV demand that the HIV program continue at least for another five years till 2022, after the current NACP winds up in 2017," said Santosh Giri, a transgender activist.
Another facet is the obstruction in the release of funds which would be clamped down due to the integration, said Smarajit Jana, Chief Advisor to DMSC and public health scientist.
"The funds release will have to go through bureaucratic procedures. This will compromise prevention and monitoring initiatives among the communities and in turn number of cases will shoot up in India.
"The planning and development of new projects will be hampered and proper focus will not be given to HIV/AIDS," he said.
The experts also called for proper consultation with the community-based organisations before effecting the merger.