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Panel: Merge AIDS project with NRHM

March 24, 2012

India’s HIV-control programme could soon get merged with the flagship National Rural Health Mission, if the Planning Commission has its way.
The panel’s steering committee on health for the 12th five-year Plan proposes “incorporating AIDS control, universal healthcare and universal access to essential medicines” into NRHM.
Planning Commission member in-charge of health Syeda Hameed said: “It is a serious recommendation to incorporate NACO under an overall National Health Mission rather that a single vertical programme.”
The proposal has left the health ministry and the National AIDS Control Organization unhappy. Health secretary P K Pradhan said: “We have told the Planning Commission this recommendation can’t work. AIDS control is a specialized issue, and needs focused attention.”
Pradhan added that AIDS control cannot be carried out by auxiliary nurse nidwives (ANMs). “Containing AIDS and HIV in India will require dealing with sex workers, injectible drug users, transgenders and men who have sex with men. It is a different clientele compared to the work ANMs do now. We are not in favour of the merger,” he said.
Hameed disagrees: “It’s all about training ANMs on how to carry out AIDS control. We, however, don’t want to burden them too much. The steering committee report will undergo three levels of approval. We are confident of pushing it through.”
The steering committee report says: “Impressive gains by national health programmes, including NRHM and other disease-control programmes, now need to be channelled to deliver Universal Healthcare in all urban and rural areas in the 12th Plan period.”
It adds: “The process should start in the first year of the Plan with Universal Healthcare pilots being run in one district of each state and UT. Concurrently, the management structure of national health programmes needs to take steps to prepare for UHC. Key recommendations on this transition is reorienting from vertical disease based approach to a holistic, health-promotion strategy based on strengthening of health systems.”
The panel says the B K Chaturvedi committee on restructuring of centrally sponsored schemes has also recommended merger of individual disease control programmes. “The NRHM governance structure should be used to provide leadership to all national health programmes. Operations under national disease control programmes should be harmonized under NRHM to avoid duplication and provide convergent services in a cost-effective way,” the report says.
India launched the first National AIDS Control Programme in 1992 and NACP II was initiated 1998. NACP III (2007-12) was designed to “halt and reverse the HIV epidemic in India” by the end of the project. There has been a steady decline in overall prevalence, and nearly 50% dip in new infections over the last 10 years.

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Categories: Public Health
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