New Delhi: The National Democratic Alliance (NDA) government has merged the country’s AIDS control department with another department in the health ministry in a move that seems to be prompted by a desire to shrink government but which, activists claim, will dilute the focus and reduce the efficacy of the successful Department of Aids Control, better known as the National Aids Control Organization (Naco).
The change will mean that India’s HIV prevention efforts will now be implemented under the National Health Mission (NHM), and not by a specific department.
According to people in the health ministry, the change is in keeping with Prime Minister Narendra Modi’s desire to shrink government, as exemplified in a slogan he popularized, “Minimum government, maximum governance”. Health minister Harsh Vardhan and mission director of NHM, Amit Kumar Ghosh, did not respond to calls or messages.
A senior official in the health ministry confirmed that the AIDS control department was being merged.
“Yes. We have been notified last week. In essence, the structure of the organization will remain the same but the department will not have a special secretary any more. The government felt there was no need for a special department. I am, however, not privy to the exact reasoning behind this decision,” added this person who spoke on the condition of anonymity.
Senior officials at Naco said they weren’t aware of the change.
Naco was created in 1992 to steer the country’s fight against HIV/AIDS. The Department of Aids Control has a secretary level official heading it.
Public health experts argue that the proposed merger of the AIDS response programme with NHM will dilute the specificity of community-based responses and will make invisible marginalized groups such as men who have sex with men and commercial sex workers.
The decision comes a month after health minister Vardhan’s controversial statements about sex education and the use of condoms.
“We have barely managed to get the programme running. We are still dealing with issues like stigma, drug stock outs in various parts of the country because the money isn’t being channelled efficiently. A merger will just ensure the programme gets caught in bureaucratic hurdles,” said Leena Menghaney, lawyer with Access Campaign, Doctors Without Borders.
AIDS workers and activists across the country are demanding an immediate reversal of the decision that they say was taken without any consultation with stakeholders and civil society.
“The decision will push back all the progress made on HIV prevention and care, but also tarnish India’s global image as a leader in this area,” said Anandi Yuvaraj, member of the International Community of Women with HIV. Like Menghaney, she too believes the change will mean “no space under the big umbrella of the National Health Mission” for marginalized groups.
India has the third-highest number of people living with HIV in the world, according to Yuvaraj.
NACO data shows that India has over 2 million HIV affected people, with high prevalence among injecting drug users, commercial sex workers and men who have sex with men.
India reported its first HIV/AIDS case in 1986; given the rapid spread of HIV/AIDS, the government created a National AIDS Committee which then felt the need for a separate department to draw up and implement a nationwide programme.
NACO, under the Department of Aids Control, was established in 1992 as a separate division of the health ministry.
It currently runs 35 state-level AIDS control societies, through which India’s national HIV/AIDS prevention programmes are implemented.