Monday, December 16, 2013

Health Ministry worried SC verdict will affect AIDS control


  • Over the recent order of the Supreme Court, stating gay sex is illegal, the Health and Family Welfare Ministry has expressed its concerns saying that- this would prevent vulnerable communities from accessing health facilities for fear of discrimination and stigma.
  • The LGBT (lesbian, gay, bisexual and transgender) is defined as a high-risk group by the National AIDS Control Organisation(NACO; now Dept. of AIDS Control )with HIV infection prevalence among men having sex with men (MSM) being the highest, between 6.5 and 7.2 %. This is the second most vulnerable community after injection drug users.
  • According to the NACO 2010-11 annual report, India had an estimated 40 lakh persons in the MSM community, of whom 10% were at risk of contracting HIV infection.
  • The Department of AIDS Control provides inclusive healthcare service for gay men and transgenders primarily for checking HIV infections, and the service was being accessed by a large number of the LGBT community following the 2009 Delhi High Court judgement that had struck down Section 377 of the Indian Penal Code which criminalised “unnatural sex.”
  • The HIV Estimation of 2012 suggests an overall reduction of 57% in the annual new HIV infections (among adult population) from 2.74 lakh in 2000 to 1.16 lakh in 2011, reflecting the impact of various interventions and scaled-up prevention strategies.
  • Based on these outcomes, the Department of AIDS Control designed the fourth phase of NACP (2012-17) to accelerate the process of reversal and further strengthen the epidemic response. The main objectives of NACP are reducing new infections and providing comprehensive care and support to all People Living with HIV and treatment services for all those who require them.
  • While HIV prevalence shows declining trends among female sex workers, MSM, injecting drug users and single male migrants are emerging as important risk groups.
Reaction across the globe regarding ‘same-sex’ marriage:
  • ‘Don’t discriminate against LGBT’ U.N. chief, the Secretary-General has re-affirmed that all human beings are born free and equal in dignity and rights and stressed the need to recommit ourselves to building a world of freedom and equality for all.
  • While UK has supported gay marriage, Australia’s top court has overruled gay marriage ruling that Parliament must decide on same-sex unions
  • The Marriage Act of Australia does not now provide for the formation or recognition of marriage between same-sex couples.
India’s Response to HIV/AIDS:
  • Shortly after reporting the first AIDS case in 1986, the Government of India established a National AIDS Control Program (NACP) which has now become the Department of AIDS under Ministry of Health and Family Welfare.
  • In 1991, the scope of NACP was expanded to focus on blood safety, prevention among high risk populations, raising awareness in the general population, and improving surveillance. A semi‐autonomous body, the National AIDS Control Organization (NACO), was established under the Ministry of Health and Family Welfare to implement this program. This “first phase” of the National AIDS Control Program lasted from 1992-1999. It focused on initiating a national commitment, increasing awareness and addressing blood safety.
  • The second phase of the NACP began in 1999 and ended in March 2006. Under this phase, India continued to expand the program at the state level. Greater emphasis was placed on targeted interventions for the most at risk populations, preventive interventions among the general population, and involvement of NGOs and other sectors and line departments, such as education, transport and police.
  • The Third Phase of NACP (NACP 3) program has dramatically scaling up targeted interventions in order to achieve a very high coverage of the most at risk groups. Under this phase, surveillance and strategic information management also receive a big boost. Partnerships with civil society organizations was at paramount in the implementation of the program with special focus on involvement of community in the program planning and implementation.
  • NACP IV -The focus of this phase will be primarily on scaling up prevention through NGOs and sustaining the efforts and results gained in last 3 phases and integration with the health systems response to the epidemic e.g. through provision of ART, STI services, and treatment of opportunistic infections through the National Rural Health Mission.

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