Budget 2008: Rs 900 crore for combating AIDS comes with responsibility

[Guest guest]

Budget 2008: Rs 900 crore for combating AIDS comes with additional

responsibility

Joe

AIDS INDIA e FORUM (3rd March) The 2008, Indian budget gives a strong

signal of heightened political support to HIV response in India. The

Union Finance Minister P Chidambaram announced the proposal of Rs.993

crore to the National AIDS Control Programme (NACP). But, such

significant resource allocation comes with additional responsibilities

The over all allocation for health sector also has marked an increase

of 15 per cent over the allocation in 2007-2008. The finance

minister proposed to allocate Rs.16,534 crore for the sector

(including North Eastern Rregion). The National Rural Health Mission

(NRHM) is the key instrument of intervention by the Central

Government. The goal of NRHM is to establish a fully functional,

community owned, decentralised health delivery system. 462,000

Associated Social Health Activists (ASHAs) and link workers have been

trained and are in place. 177,924 Village Health and Sanitation

Committees are functional. 323 district hospitals have been taken up

for up gradation. Ambitious goals have been set for 2008-09. The

allocation for NRHM has been increased to Rs.12,050 crore .

P Chidambaram told in his speech, Studies have shown that the

prevalence rate of HIV/AIDS has come down from 0.9 per cent to 0.36

per cent, which is a matter of some satisfaction for him. However,

what he failed mention is the reduction in prevalence rate is not an

indication of the reduction in HIV vulnerability.

In addition to the additional budget allocation, Chdambaram also

announced the total exemption of excise duty on the anti AIDS drug

Atazanavir and bulk drugs for its manufactures. The railway budget,

which was presented to the parliament few days ago also has been

generous to people living with HIV/AIDS.

Additional resources comes with additional responsibility

However, in the din of the additional resources, one may tent to

forget the fact that the additional resources comes with additional

responsibility. The following are some of the issues which needs

urgent attention from leaders of Indian `HIV/AIDS sector'

Responsibility 1. Commitment to Health Equity

Perhaps, it is time for a comprehensive mid term review of the 3rd

National AIDS Control Program (NACP 3). One of the significant

drawbacks of NACP3 is a lack of emphasis of health equity. Large

section of marginalized sections of society and people from rural and

remote areas are treated unfavorably in the plan. A detailed analysis

of -who gets what -out of NACP 3 is essential. It seems, NACP 3 has

to take corrective measures to address the prevention and care needs

particularly of ethnic minority (Tribal) populations and rural women.

Responsibility 2 Commitment to MDG 6

Government of India made a solemn commitment to the global community

that it would endower to achieve millennium development goals

(MDGs) Accordingly, NACP 3 need to be analyzed from the point of

view of how far NACP3 would contribute to the Millennium Development

Goal 6. The Goal 6 of the Millennium Development Goals sets out by

the year 2015 to: Halt and begin to reverse the spread of HIV/AIDS.

Responsibility 3. Promoting good governance

With the additional resources allocated in the budget, NACP3 must

promote good governance in HIV response in all levels. Community

level, Civil society level and at State AIDS Control Society (SACS)

level and at National level. A collectively agreed code of conduct

for the `AIDS sector' would be a good beginning towards this

direction.

Indian agencies, particularly Indian AIDS NGOs need to demonstrate

greater political maturity in participatory democracy. One of the

significant lapse from the part of Indian AIDS NGOs are their

inability to develop a broad based, democratically representative

National NGO FORUM – Perhaps, it is time to form a National

Federation of AIDS NGOs in India, which would democratically

represent the interest of AIDS NGO sector in India.

Responsibility 4. Monitoring HIV response in the district level

We have yet to put to rest to the `HIV number controversy'. For

instance, still now we don't have a district level, numbers of

reported case of HIV/AIDS. NACP 3 must have system by which on a

monthly basis, district level HIV data, including the district level

reported cases are made available publicly.

Responsibility 5 A National priority HIV Research agenda and resource

allocation.

One of the critical limitations of NACP 3 is lack of a clear priority

HIV Research agenda and resource allocation to implement such a

research agenda. Research based data should guide HIV related

policies and our understanding of the epidemic. In the absence of

such local research data, HIV policies could be held captive of,

national and international vested interests.