NACP - National AIDS Control Programme (SPM / Park's)

Overview

• Prevent further transmission of HIV
• Decrease morbidity and mortality associated with HIV infection
• Minimize the socio-economic impact of HIV infection

Historical Milestones

Phases of NACP

NACP-I (1992-1999)

• Objective: Slow down the spread of HIV infection
• Key activities: Blood safety, STD control, awareness, IEC

NACP-II (1999-2006)

• Objective: Reduce spread of HIV infection and strengthen India's capacity to respond
• Focus: Behaviour change communication, decentralization, NGO involvement
• State AIDS Control Societies established

NACP-III (2007-2012)

• Objective: Halt and reverse the epidemic
• Strategy: Prevention, Care, Support and Treatment
• Guiding Principles ("Three Ones"):
  • One Agreed Action Framework
  • One National HIV/AIDS Coordinating Authority
  • One Agreed National Monitoring and Evaluation System
• Key components: Targeted Interventions (TI) for High Risk Groups (HRGs), ART scale-up, Prevention of Parent-to-Child Transmission (PPTCT), Blood Safety, IEC/BCC

NACP-IV (2012-2017)

• Objective: Reduce new HIV infections by 50% (from NACP-III baseline) and provide comprehensive care and support to all PLHIV
• Strategic focus areas:
  1. Intensifying and consolidating prevention services with focus on HRGs and vulnerable population
  2. Increasing access and promoting comprehensive care, support and treatment
  3. Expanding IEC services for general population with focus on vulnerable groups
  4. Building capacities at state, district, and facility levels
  5. Strengthening the strategic information management system

National Strategy Components (NACP)

1. Establishment of surveillance centres to cover the whole country
2. Identification of high-risk groups (HRG) and their screening
3. Issuing specific guidelines for management and follow-up of detected cases
4. Guidelines for blood banks, blood product manufacturers, blood donors, and dialysis units
5. IEC (Information, Education, Communication) activities through mass media
6. Research to reduce personal and social impact of disease
7. Control of STDs (Sexually Transmitted Diseases)
8. Condom programme

District Categorization (for Targeted Interventions)

HIV Sentinel Surveillance

• Started in 1994 with 55 sentinel sites; increased to 180 sites by 1998
• Unlinked anonymous serological testing (ERS - Epidemiological Reference System)
• Antenatal clinic (ANC) attendees used as proxy for general population
• Annual cross-sectional surveys of risk groups
• High-Risk Groups monitored: STD clinic attendees, CSW (Commercial Sex Workers), MSM (Men who have Sex with Men), IDU (Intravenous Drug Users)

NACP - Key Targets (NACP-IV)

• Reduce new annual HIV infections by 50%
• Provide ART to all who need it (universal access)
• Reduce AIDS-related deaths
• Eliminate PPTCT (Parent-to-Child Transmission)
• Achieve zero new infections in children

TB-HIV Coordination

• NACP and RNTCP (Revised National TB Control Programme) have a joint policy to adopt Isoniazid Prophylaxis Therapy (IPT) as a strategy for prevention of TB among PLHIV (People Living with HIV)

Current Phase: NSP 2017-2024 (and extended to 2025)

• 90% of PLHIV know their status
• 90% of those diagnosed receive ART
• 90% on ART achieve viral suppression