National AIDS control programme

The National AIDS Control Programme (NACP), launched in 1992, is being implemented as a comprehensive programme for prevention and control of HIV/ AIDS in India. Over time, the focus has shifted from raising awareness to behaviour change, from a national response to a more decentralized response and to increasing involvement of NGOs and networks of People living with HIV (PLHIV).

The NACP I started in 1992 was implemented with an objective of slowing down the spread of HIV infections so as to reduce morbidity, mortality and impact of AIDS in the country.

In November 1999, the second National AIDS Control Project (NACP II) was launched to reduce the spread of HIV infection in India, and (ii) to increase India’s capacity to respond to HIV/AIDS on a long-term basis.

NACP III was launched in July 2007 with the goal of Halting and Reversing the Epidemic over its five-year period.

NACP IV, launched in 2012, aims to accelerate the process of reversal and further strengthen the epidemic response in India through a cautious and well defined integration process over the next five years.

NACP V was implemented as a Central Sector Scheme fully funded by the Government of India from 1st April 2021 to 31st March 2026 with an outlay of Rs 15471.94 crore.

NACP V

The NACP Phase-V will take the national AIDS and STD response towards the attainment of United Nations’ Sustainable Development Goals 3.3 of ending the HIV/AIDS epidemic as a public health threat by 2030 through a comprehensive package of prevention, detection and treatment services.

The Phase-V builds upon the gamechanger initiatives of the HIV/AIDS Prevention and Control Act (2017), Test and Treat Policy, Universal Viral Load Testing, Mission Sampark, Community-Based Screening, transition to Dolutegravir-based Treatment Regimen etc and introduces newer strategies consolidating and augmenting the gains. This include setting-up of Sampoorna Suraksha Kendras (SSK) for providing services through a single window model for those “at risk” for HIV and STI covering prevention-test-treat-care continuum. It includes a holistic set of services customized as per clients’ needs, with strong linkages and referrals within and outside of health systems.

NACP - IV

Objectives

• Reduce new infections by 50% (2007 Baseline of NACP III)
• Provide comprehensive care and support to all persons living with HIV/AIDS and treatment services for all those who require it.

Key strategies

• Intensifying and consolidating prevention services, with a focus on HIgh Risk Groups (HRGs) and vulnerable population.
• Increasing access and promoting comprehensive care, support and treatment
• Expanding IEC services for (a) general population and (b) high risk groups with a focus on behaviour change and demand generation.
• Building capacities at national, state, district and facility levels
• Strengthening Strategic Information Management System

Key priorities under NACP IV

• Preventing new infections by sustaining the reach of current interventions and effectively addressing emerging epidemics
• Prevention of Parent to Child transmission
• Focusing on IEC strategies for behaviour change in HRG, awareness among general population and demand generation for HIV services
• Providing comprehensive care, support and treatment to eligible PLHIV
• Reducing stigma and discrimination through Greater involvement of PLHA (GIPA)
• De-centralizing rollout of services including technical support
• Ensuring effective use of strategic information at all levels of programme
• Building capacities of NGO and civil society partners especially in states with emerging epidemics
• Integrating HIV services with health systems in a phased manner
• Mainstreaming of HIV/ AIDS activities with all key central/state level Ministries/ departments will be given a high priority and resources of the respective departments will be leveraged. Social protection and insurance mechanisms for PLHIV will be strengthened.

Package of services provided under NACP IV

Prevention Services

• Targeted Interventions for High Risk Groups and Bridge Population (Female Sex Workers (FSW), Men who have Sex with Men (MSM), Transgenders/Hijras, Injecting Drug Users (IDU), Truckers & Migrants)
• Needle-Syringe Exchange Programme (NSEP) and Opioid Substitution Therapy (OST) for IDUs
• Prevention Interventions for Migrant population at source, transit and destination
• Link Worker Scheme (LWS) for HRGs and vulnerable population in rural areas
• Prevention & Control of Sexually Transmitted Infections/Reproductive Tract Infections (STI/RTI)
• Blood Safety
• HIV Counseling & Testing Services 8. Prevention of Parent to Child Transmission
• Condom promotion
• Information, Education & Communication (IEC) & Behaviour Change Communication (BCC).
• Social Mobilization, Youth Interventions and Adolescent Education Programme
• Mainstreaming HIV/AIDS response
• Work Place Interventions

Care, Support & Treatment Services

• Laboratory services for CD4 Testing and other investigations
• Free First line & second line Anti-Retroviral Treatment (ART) through ART centres and Link ART Centres (LACs), Centres of Excellence (COE) & ART plus Centres.
• Pediatric ART for children
• Early Infant Diagnosis for HIV exposed infants and children below 18 months
• HIV-TB Coordination (Cross- referral, detection and treatment of co-infections)
• Treatment of Opportunistic Infections
• Drop-in Centres for PLHIV networks

New Initiatives under NACP IV

• Differential strategies for districts based on data triangulation with due weightage to vulnerabilities
• Scale up of programmes to target key vulnerabilities
• Scale up of Opioid Substitution Therapy (OST) for IDUs
• Scale up and strengthening of Migrant Interventions at Source, Transit & Destinations including roll out of Migrant Tracking System for effective outreach
• Establishment and scale up of interventions for Transgenders (TGs) by bringing in community participation and focused strategies to address their vulnerabilities
• Employer-Led Model for addressing vulnerabilities among migrant labour e. Female Condom Programme
• Scale up of Multi-Drug Regimen for Prevention of Parent to Child Transmission (PPTCT) in keeping with international protocols
• Social protection for marginalised populations through mainstreaming and earmarking budgets for HIV among concerned government departments
• Establishment of Metro Blood Banks and Plasma Fractionation Centre
• Launch of Third Line ART and scale up of first and second Line ART
• Demand promotion strategies specially using mid-media, e.g., National Folk Media Campaign & Red Ribbon Express and buses (in convergence with the National Health Mission)

Source : NACO