ਇਤਿਹਾਸ

Punjab State AIDS Control Society (PSACS) was registered in 1998 for implementing National AIDS Control Programme (NACP). NACP is a 100% centrally sponsored project. PSACS started functioning in 1999. Principal Secretary Health is the Chairman of the Society whereas Secretary Health has been designated as Project Director of the society. Additional Project Director is the technical head assisted by Joint Directors, Deputy Directors, Assistant Directors, other officers and supporting staff.

• NACP I (1992-1999) : The first phase of National AIDS Control Programme (NACP-I), was implemented between 1992 and 1999, with an objective to combat the Human Immuno-deficiency Virus (HIV) infection and Acquired Immuno-Deficiency Syndrome (AIDS) in the initial stage itself. The first phase focused on awareness generation, setting up surveillance systems for monitoring the HIV epidemic, taking measures to ensure access to safe blood and preventive services for high risk group populations.
• NACP II (1999-2006): The second phase of the programme, NACP II was launched towards the end of 1999 with two key objectives: 1) To reduce the spread of HIV infection in India; 2)To increase the country’s capacity to respond to HIV/ AIDS over time. The programme were considerably scaled up during NACP II including: i) interventions targeted among commercial FSWs, MSM, TG and IDU to facilitate changes in behaviors; ii) increased number of licensed blood banks and establishment of National Blood Policy; and iii) strengthening of the HIV sentinel surveillance.

Under NACP II the use of society model for state level implementation was institutionalized, and State AIDS Control Societies (SACS) were registered for effective programme management.

• NACP III (2007-2013): NACP phase III, launched in July 2007, aimed at “Halting and reversing the epidemic” before the end of the project period. The programme became well-evolved and grounded on strong policies, programmes, with extensive operational guidelines, rules and norms. During NACP III prevention efforts among HRG and general population were scaled up and integrated with care, support and treatment (CST) services. Strategic Information Management and Institutional strengthening activities were taken up to provide the required technical, managerial and administrative support for implementation at the national, state and district levels. State Training and Resource Centres (STRC) were set up to help state implementation units and functionaries. The decentralization process started under NACP II was further strengthened to better reach populations at the district and sub-district levels through District AIDS Prevention and Control Units (DAPCUs). NACPIII explicitly institutionalized an evidence-based programming approach, and created a Strategic Information Management Unit (SIMU).Technical Support Units (TSUs) were also established at the national and state levels to strengthen the technical capacity and programme monitoring.

• NACP-IV(2013-Present): NACP IV (2012-17) aims to consolidate the gains made till now and accelerate the process of reversal and further strengthen the epidemic response. The key strategies of NACP IV are:

Component 1: Intensifying and Consolidating Prevention services with a focus on HRG and vulnerable populations

This component will support the scaling up of TIs with the aim of reaching out to the hard to reach population groups who do not yet access and use the prevention services of the program, and saturate coverage among the HRGs. In addition, this component will support the bridge population, i.e. migrants and truckers. Component 1 includes the following two subcomponents:

1.1 Scaling up coverage of TIs among HRG

The interventions under this sub-component will include: (i) the provision of behavior change interventions to increase safe practices, testing and counseling, and adherence to treatment, and demand for other services;(ii) the promotion and provision of condoms to HRG to promote their use in each sexual encounter; (iii) provision or referral for STI services including counseling at service provision centers to increase compliance of patients with treatment, risk reduction counseling with focus on partner referral and management; (iv) needle and syringe exchange for IDUs as well as scaling up of Opioid Substitution Therapy (OST) provision. This sub-component also includes the financing of operating costs for about 25 State Training Resource Centers as well as participant training costs over a period of 5 years.

1.2 Scaling up of interventions among other vulnerable populations

The activities under this subcomponent will include: (i) risk assessment and size estimation of migrant population groups and truckers at transit points and at workplaces; (ii) behavior change communications (BCC) for creating awareness about risk and vulnerability, prevention methods, availability and location of services, increase safe behavior and demand for services as well as reduce stigma;(iii) promotion and provisioning of condoms through different channels including social marketing; (iv) development of linkages with local institutions, both public and NGO owned, for testing, counseling and STI treatment services;(v) creation of “peer support groups” and “safe spaces” for migrants at destination; (vi) establishment of need-based and gender-sensitive services for partners of IDUs; and(vii) strengthening networks of vulnerable populations with enhanced linkages to service centers and risk reduction interventions, specifically condom use.

Component 2: Expanding IEC services for (a) general population and (b) high risk groups with a focus on behavior change and demand generation

IEC has been an important component of the NACP. With the expansion of services for counseling and testing, ART, STI treatment and condom promotion, the demand generation campaigns will continue to be the focus of the NACP-IV communication strategy. IEC will remain an important component of all prevention efforts and will include:

• Behavior change communication strategies for HRGs, vulnerable groups and hard to reach populations
• Increasing awareness among general population, particularly women and youth.

Component 3: Increasing access and promoting Comprehensive Care, Support and Treatment

NACP IV will implement comprehensive HIV care for all those who are in need of such services and facilitate additional support systems for women and children affected and infected with HIV / AIDS. It is envisaged that greater adherence and compliance would be possible with wide network of treatment facilities and collaborative support from PLHIV and civil society groups. Additional Centers of Excellence (CoEs) and upgraded ART Plus centers will be established to provide high-quality treatment and follow-up services, positive prevention and better linkages with health care providers in the periphery.

With increasing maturity of the epidemic, it is very likely that there will be greater demand for 2nd line ART, OI management. NACP IV will address these needs adequately. It is proposed that the comprehensive care, support and treatment of HIV/AIDS will inter alia include: (i) anti-retroviral treatment (ART) including second line (ii) management of opportunistic infections and (iii) facilitating social protection through linkages with concerned Departments/Ministries. The program will explore avenues of public-private partnerships. The program will enhance activities to reduce stigma and discrimination at all levels particularly at health care settings.

Component 4: Strengthening institutional capacities

The objective of NACP IV will be to consolidate the trend of reversal of the epidemic seen at the national level to all the key districts in India. Programme planning and management responsibilities will be strengthened at state and district levels to ensure high quality, timely and effective implementation of field level activities and desired programmatic outcomes.

The planning processes and systems will be further strengthened to ensure that the annual action plans are based on evidence, local priorities and in alignment with NACP IV objectives. Sustaining the epidemic response through increased collaboration and convergence, where feasible, with other departments will be given a high priority during NACP IV. This will involve phased integration of the HIV services with the routine public sector health delivery systems, streamlining the supply chain mechanisms and quality control mechanisms and building capacities of governmental and non-governmental institutions and networks.

Component 5: Strategic Information Management Systems (SIMS)

The roll-out of SIMS is ongoing and will be firmly established at all levels to support evidence based planning, program monitoring and measuring of programmatic impacts. The surveillance system will be further strengthened with focus on tracking the epidemic, incidence analysis, identifying pockets of infection and estimating the burden of infection. Research priorities will also be customized to the emerging needs of the program. NACP IV will also document, manage and disseminate evidence and effective utilization of programmatic and research data. The relevant, measurable and verifiable indicators will be identified and used appropriately.