National AIDS Control Programme

1. Demonstrated by : Megha Devgan & Mehak Khanna

3. Burden of HIV in india
Among the States/UTs, in 2017,
Maharashtra has the highest
estimated number of PLHIV (3.30
Lakhs, 2.53-4.35) followed by
Andhra Pradesh (2.70 Lakh, 2.00-
3.58), Karnataka (2.47 Lakh, 1.91-
3.23), Telangana (2.04 Lakh, 1.49-
2.77), West Bengal (1.44 Lakh,
1.03-1.91), Tamil Nadu (1.42 Lakh,
0.93-1.97), Uttar Pradesh (1.34
Lakh, 1.01-1.77) and Bihar (1.15
Lakh, 0.83-1.58). These Eight
States together account for
almost three fourth (75.00 %) of
total estimated PLHIV. Other all
states have less than 1 lakh
people living with HIV.

5. History
• 1981, cases of Pneumocystis carinii
pneumonia (PCP) in 5 gay men in Los
Angeles
• New York and California reported
with Kaposi’s Sarcoma (KS).
• 1981, December- PCP were reported
in people who inject drugs.
• 270 reported cases of severe immune
deficiency among gay men - 121 of
them had died
• 1982- initially called gay-related
immune deficiency (GRID)

6. Suniti Solomon
•Diagnosed the first Indian cases in
Chennai in 1986.
•In 2009, she was awarded , “National
Women Bio-scientist Award” by the Indian
ministry of Science and Technology.
•On 25th January 2017, Govt. of India
announced “Padma shri” award for her
contribution towards Medicine
•“what is killing people with AIDS more is
the stigma and discrimination”

7. INTRODUCTION
• HIV is the Human Immunodeficiency Virus- lentivirus -
retrovirus
• Leads to Acquired Immune Deficiency Syndrome, or
AIDS.
• Destroy specific blood cells, called CD4+ T cells, which
are crucial for fighting diseases.
• No cure for HIV infection.
• Currently, people can live much longer - even decades -
with HIV before they develop AIDS.
• “Highly active” combinations of medications that were
introduced in the mid 1990s.

8. Modes of transmission

10. 2012-2017

11. AIDS Control Programme in India
• HIV infection first detected in India in 1986, when
10 HIV positive samples were found from a group
of 102 female sex workers from Chennai.
• In 1986 Government set up an AIDS Task Force
under ICMR and established a National AIDS
Committee (NAC) chaired by Secretary,
Department of Health and Family Welfare.
• In 1987, National AIDS Control Programme was
initiated, with help from the World Bank.
• In 1989, a Medium Term Plan for AIDS Control
was developed with the support of the WHO.

12. AIDS Control Programme in India
• First National AIDS Control Programme (NACP-I)
was launched in 1992.
• NACP-II launched in 1999: decentralization of
programme implementation to State level and
greater involvement of NGOs.
• NACP- III implemented during 2007-2012:
scaling up HIV prevention interventions for HRG
and general population, and integrate them with
Care, Support & Treatment services.
• NACP-IV has been developed for the period
2012-2017

13. NACP-I
1992, IDA (International Development Association) Credit of USD
84 million, commitment to combat the disease.
OBJECTIVE:
slowing down the spread of HIV infections so as to reduce
morbidity, mortality and impact of AIDS in the country.
KEY STRATEGIES:
• NACB was constituted and an autonomous NACO was set up to
implement the project
• awareness generation
• setting up surveillance system
• access to safe blood and preventive services for high risk group
populations

14. NACP-II
1999 November, World Bank credit support of USD 191 million
OBJECTIVE
Reduce the spread of HIV infection in India through behavior change and increase
capacity to respond to HIV on a long-term basis.
KEY STRATEGIES
• National AIDS Prevention and Control Policy (2002);
• Scale up of Targeted Interventions for High risk groups in high prevalence states
• National Blood Policy
• Greater Involvement of People with HIV/AIDS (GIPA)
• National Adolescent Education Programme (NAEP)
• Introduction of counselling, testing and PPTCT
• National Anti-Retroviral Treatment (ART) programme
• Inter-ministerial group for mainstreaming
• National Council on AIDS
• Setting up of State AIDS Control Societies in all states

15. NACP-III
Formed in 2007, July
GOAL: Halting and Reversing the Epidemic by the end of project period
KEY PILLARS:
• Prevention among HRG and general population
• Care, support and treatment
KEY STRATEGIES:
• Prevention – Targeted intervention (TI), ICTC, blood safety,
communication, advocacy and mobilisation, condom promotion.
• The capacities of SACS and DAPCUs have been strengthened
• Technical Support Units (TSUs) established
• Dedicated North-East regional Office established
• State Training Resource Centres (STRC) set up
• Strategic Information Management System (SIMS) established

16. NACP-IV
Launched on 12 February 2014.
Total budget outlay Rs 14295 crores.
OBJECTIVES:
• Objective 1: Reduce new infections by 50% .
• Objective 2: Comprehensive care, support and
treatment to all persons living with HIV/AIDS.

17. Key strategies under NACP-iv

18. implementation structure
District AIDS Prevention and
Control Units(DAPCUs)
• 188 District AIDS Prevention and
Control Units(DAPCUs) with a
team of field.
• functionaries in A and B category
districts for decentralized
programme implementation.
States AIDS Control
Societies(SACS)
• The NACP is implemented through
35 SACS in the states and UTs
• A governing body headed by the
minister in charge of health/ the
chief secretary
• It approves new policy initiatives,
annual plan and budget, appoints
statutory auditors and accepts the
annual audit report
FUNCTIONS:
• Medical and public health services;
• Communication and social sector
services; and
• Administration, planning,
coordination, monitoring and
evaluation, finance

19. organogram
Centres of Excellence-
alternate First line &
Second line ART
ART Centres
+
Tertiary level care
Medical Colleges
Districts with low seropositivity
may have LAC only

20. Organogram

21. The package of services provided under
NACP-IV includes:
A) PREVENTION SERVICES:
● Targeted Interventions (TI) 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(Opioid substitution therapy supplies
illicit drug users with a replacement drug, a
prescribed medicine such as methadone or
buprenorphine, which is usually administered
orally in a supervised clinical setting.);
● Link Worker Scheme (LWS) for High Risk Groups
and vulnerable population in rural areas;
● Prevention & Control of Sexually Transmitted
Infections/Reproductive Tract Infections
(STI/RTI);
● Blood Transfusion Services;
● HIV Counselling & Testing Services eg.
Transmission Integrated Counselling and
Testing Centre (ICTC), Prevention of Parent-
to-Child Transmission(PPCT) of HIV and
HIV/Tuberculosis collaborative activities;
● Condom promotion;
● Information, Education & Communication
(IEC) and Behaviour Change Communication
(BCC)–Mass Media Campaigns through
Radio & TV, Mid-media campaigns through
Folk Media, display panels, banners, wall
writings etc., special campaigns through
music and sports, flagship programmes,
such as Red Ribbon Express;
● Social Mobilization, Youth Interventions and
Adolescence Education Programme;

22. TARGETED INTERVENTIONS(TI)

23. B) CARE, SUPPORT & TREATMENT SERVICES:
● Laboratory services for CD4 Testing, Viral
Load testing, Early Infant Diagnosis of HIV
in infants and children up to 18 months
age and confirmatory diagnosis of HIV-2;
● Free first line & second line Anti-Retroviral
Treatment (ART) through ART Centres and
link ART Centres, Centres of Excellence &
ART plus centres;
● Pediatric ART for children;
● Nutritional and psycho-social support
through community and support centres;
● HIV-TB coordination (Cross-referral,
detection and treatment of co-infections)
● Treatment of Opportunistic Infections.

24. Combination prevention
Combination prevention advocates for a holistic approach whereby HIV
prevention is not a single intervention (such as condom distribution) but the
simultaneous use of complementary behavioural, biomedical and structural
prevention strategies.

27. SEXUALLY TRANSMITTED INFECTIONS (STI) AND REPRODUCTIVE TRACT
INFECTION (RTI) CONTROL & PREVENTION PROGRAMME

30. World AIDS Day, 1st December
Every year 1st December is
observed as World AIDS Day
(WAD). The day is an opportunity
for people worldwide to unite in
the fight against HIV, show their
support for people living with
HIV. On World AIDS Day,
awareness activities are
implemented at grass root levels
by States involving communities,
NGOs, Youth etc. opportunity

31. acronyms
1) NACP: National AIDS Control Programme
2) NACB: National AIDS Control Board
3) NACO: National AIDS Control Organization
4) ANC: Antenatal Clinic
5) AIDS: Acquired Immuno Deficiency
Syndrome
6) ART: Anti Retroviral Therapy
7) BCC: Behaviour Change Communication
8) DAPCUs: District AIDS Prevention &
Control Units
9) GRID: Gay Related Immuno Deficiency
10) GIPA: Greater Involvement of People with
HIV/AIDS
11) HRG: High Risk Groups
12) HIV: Human Immunodeficiency Virus
13) ICMR: Indian Council of Medical Research
14) IDU: Injecting Drug Users
15) IEC: Information, Education and
Communication
16) ICTC: Integrated Counseling and Testing Centre
17) KS: Kaposi’s Sarcoma
18) LAC: Link ART Centre
19) LWS: Link Worker Scheme
20) NSEP: Needle-Syringe Exchange Programme
21) NAEP: National Adolescent Education
Programme
22) PCP: Pneumocystis carinii pneumonia
23) PLHIV: People Living with HIV
24) PPTCT: Prevention of Parent-to-Child
Transmission
25) SACS: State AIDS Control Society
26) SIMS: Strategic Information Management
System
27) STRC: State Training & Resource Centre
28) STI/RTI: Sexually Transmitted/ Reproductive
Tract Infection
29) TI: Targeted Intervention
30) TSUs: Technical Support Units

32. Thank you!