National AIDS Control Programme
http://www.naco.gov.in/nacp
https://vikaspedia.in/health/nrhm/national-health-
programmes-1/communicable-diseases/national-aids-control-
programme
For final year BAMS students
3rd August 2020
For internal circulation only
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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.
Milestones of the programme
• 1986- First case of HIV detected. AIDS task force set up by
ICMR. National AIDS Committee by Ministry of Health.
• 1990 – Medium term plan for states and 4 metros.
• 1992 – NACP I launched National AIDS control board
constituted. NACO set up.
• 1999 – NACP II began, SACS established
• 2002 - National AIDS control policy National blood policy
• 2004 – Antiretroviral treatment initiated
• 2006 - National council on AIDS under chairmanship of Prime
Minister . National policy on Pediatric ART
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• 2007 – NACP III launched for 5 years (2007 – 2012)
• 2012 - NACP IV launched for next 5 years
NACP I OBJECTIVE:
Slow & prevent spread of HIV through a major effort to prevent its
transmission
STRATEGIES:
• Focus on raising awareness, blood safety , prevention among
high risk populations •Improving surveillance
ACHIEVEMENTS: • Strong partnership with WHO •
Establishment ofthe state AIDS control cells • Improved blood
safety • Expanded sentinel surveillance & improved coverage and
collection of data • Improved condompromotion activities •
Development of national HIV testing policy
NACP II OBJECTIVES:
Reduce the spread of HIV infection in India through behavioral
changes & Increase capacity to respond to HIV on a long term
basis
STRATEGY: • Target interventions for high risk groups •
Preventive interventions for general populations • Involvements of
NGOs • Institutional strengthening
ACHIEVEMENTS: 1.1033 TIs, 875 VCTC, 679 STI clinics
started at district level 2.Nation wide behavioral sentinel
surveillance were conducted 3. PPTCT program was expanded
4. Computerized management information system was created 5.
HIV prevention & care and support networks were strengthened 6.
Supports from partner agencies increased
NACP III OBJECTIVES:
Reduce the rate of incidence by 60% in 1st year of program in high
prevalence states and by 40% in vulnerable states
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STRATEGY: • Prevention by TI, ICTC, Blood safety,
Communication,and condom promotion • Care ,support &
treatment-ART, CoEs, Community center • Capacitybuilding •
Strategic information management by monitoring & evaluation
ACHIEVEMENTS: 1. 306 fully functionalART center & 612
LINK ART center , 10 CoE, 259 Communitycares were
established 2. 12.5 lakh PLHIV were registered & 4.2 lakh patients
were on ART 3. 3000 Red ribbon clubs were established 4. Link
workers training module updated & condom promotion program
was strengthened
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
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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)
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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
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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
o Scale up of Opioid Substitution Therapy (OST) for
IDUs
o Scale up and strengthening of Migrant Interventions
at Source, Transit & Destinations including roll out
of Migrant Tracking System for effective outreach
o Establishment and scale up of interventions for
Transgenders (TGs) by bringing in community
participation and focused strategies to address their
vulnerabilities
o 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)
Q; Describe NACP and NACO in detail
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