Started in 1987 Ministry of Health & Family

Welfare set up NACO To prevent further transmission To decrease morbidity & mortality To minimize the socio-economic

impact

1986 – 1st caseAIDS task force by ICMRNational AIDS Committee

1990- medium term plan

1992- NACP-INational AIDS control BoardNACO

1999 – NACP II State AIDS control Society

2002 – National AIDS Control policy National blood policy

2004- Antiretroviral treatment

2006 –National Council on AIDS• National policy on paediatric ART 2007- NACP- III (2007-2012)

2014 – NACP IV (2012-2017)

Establishment of surveillance centers

Identify & screen high risk groups

Guidelines for management of case

Guidelines for blood bank & blood donors,dialysis units

Information,education&communication activities

Control of STD

Condom programme

Research

Prevention services

Intervention for high risk group& bridge groups

Needle syringe exchange programme

Control of STDs & reproductive tract infections

HIV councelling & testing services

Blood safety,parent to child transmission

Care, support & treatment services

Laboratory services

Free 1st & 2nd line ART & treatment of opportunistic infections

Paediatric ART for children

Early infant diagnosis for HIV exposed infants

3 groups

Group I : Maharashtra,TN, Karnataka, AP ,Manipur, Nagaland

Group II: Gujarat,Goa,Puduchery

Group III: remaining states

Category ANC/PTCTprevalence

HRG prevalence

Hotspot

A >1%

B < 1% >5%

C <1% <5% Y

D <1% <5% N

HIV Sentinel Surveillance HIV Sero - Surveillance AIDS Case Surveillance STD surveillance Behavioral Surveillance Integration with other disease surveillances

Inclusion of data from HRG& additional subsets of rural samples through ANC

Objectives To determine the level of infection To determine the trend HIV epidemic To understand the geographical spread & to

identify the emerging pockets To provide information for prioritization of

resources To estimate HIV prevalence & HIV burden

Since 1997 Components: ICTC PPTCT HIV/ tuberculosis collaborative activities

Early detection Provision of basic information on

modes of transmission & prevention Linking PLHIV with other HIV

prevention, care & treatment services

2 types-fixed facility & mobile ICTC Fixed facility ICTC : within an

existing health care system Standalone ICTC Facility-ICTC Mobile ICTC

Started in 2002 Aims

HIV testing to every pregnant woman To cover all the HIV positive pregnant

woman Eliminate transmission from mother-child

HIV couselling &testing to all pregnant woman

Family-centric approach

Lifelong ART for HIV +ve regardless of CD4 count

Institutional deivery promotion

Care for associated conditions

Exclusive breast feeding

ARV prophylaxis for infants

Follow-up:infants& community level

Free ART Psychosocial support Prevention & treatment of

oppurtunistic infections Facilitating home based care Impact mitigation

Aim:

SELECTED MEDICAL COLLEGES

MEDICAL COLLEGE& DISTRICT LEVEL HOSPITAL

SUB-DISTRICT HSPTL & CHCs

1st -line ART : free of cost, to PLHIV through ART centres based on C/E &CD4 counts

Alternative 1st line ART intolerance to 1st line/

2ND Line ART Rx failure

National paediatric AIDS initiative Paediatric 2nd line ART Early infant diagnosis

Detection & treatment of STIs Condom distribution,promotion Behaviour change communication Community involvement Linkages to ICTC & CST Specific intervention for IDUs Specific intervention for MSM/TGs

HIV prevention & care of HRGs & vulnerable groups in rural areas

Provide information on prevention & risk reduction

Condom promotion & distribution Provide referral & follow up linkages

Provision of safe &quality blood Coordinated transfusion service NACO supports BCSU & bloodbanks Blood storage facility at FRUs Objectives

To reduce transfusion associated HIV <0.5%

Prohibition of professional blood donation Awareness creation & capacity building Mandatory testing of blood for HIV,

HeB,HeC malaria &syphilis

NACO Quality control of condoms Social marketting of condoms Involvement of NGOs

2 approaches Syndromic management for STDs Integrate RTI management & STD

management STD clinic at FRU/Block/District level

act as referral centres for cases from periphery

Strengthening STD clinics

Massive orientation & training Atleast one NACO supported

“Suraksha clinic” per district Validate the syndromic diagnosis Monitor drug resistance Pre-packed STI/RTI colour coded kits

School AIDS Education programme Red ribbon clubs World AIDS day Print &Mass media Family Health Awareness campaign

Link worker scheme –GP & HRGs Create demand for CST services Antiretroviral treatment PPTCT National AIDS telephone Helpline – 1097