28 years of NACO: How India battled AIDS/HIV

India diagnosed its first cases of AIDS in 1986 under the guidance of Suniti Solomon, a teacher at Madras Medical College. Before Solomon decided to track the advent of AIDS in India, it was largely considered to be a disease that only affects homosexuals.

When she took on this mammoth task, India did not have the required technology to carry out Western Blots, the technique preferred for HIV diagnosis across the world. The samples had to be sent to Johns Hopkins University in the US.

In 1992, the National AIDS Control Organisation (NACO) was launched in India along with the Phase I of the National AIDS Control Programme (NACP), funded with the help of a World Bank loan. After many trials and tribulations, India was able to record success in controlling the advent of AIDS during the Phase III process of the NACP.

NACP III was launched in July 2007 with ‘the goal of Halting and Reversing the Epidemic by the end of project period’ according to NACO. And for the first time, indigenous and grounded ways were developed by the experts at NACO to halt and reverse the spread of HIV epidemic in India over a five-year period by targeting High-Risk Groups (HRG).

Involving activists who lived with HIV

NACO involved people who had been living with HIV, many of whom had already worked as activists, to target High-Risk Groups. This ushered in a new era of cooperation between the community and the government. To reach the people living on the margins of society who were part of the HRGs grassroots activists played the most significant role, right after donors.

Educating HRGs on use of protection

NACO activists worked with sex workers, long haul truck drivers, rural migrants, transgender individuals, and homosexuals to educate them on the need for protection during sexual intercourse. This was the first known movement in India that openly talked about the importance of condoms, without ostracising them. The grassroots activists carried the community work forward with their lived experience.

Innovative and effective campaigning

NACO was able to track and trace the advent of HIV in drug users through needle sharing. A specially designed campaign was launched in Manipur to educate drug users on the negative side effects of needle sharing, grassroots activists took great care in making the targeted population involved and included. NACO also partnered with many NGOs like the Naz Foundation to increase impact. A special train filled with literature on HIV awareness was flagged off from Delhi. It travelled all over the country to distribute reading material and raise awareness of HIV.

Road ahead

NACO, for the most part, has functioned as an autonomous body but over the years successive experimentations have taken its toll on its effectiveness. With significant fund cuts, NACO has started to lag behind in its efforts to combat the epidemic. The United Nations has warned the world that this ongoing coronavirus pandemic will take its toll on programs like HIV prevention as nations go through fund crunch.

“In the light of all these challenges, the Centre needs to seriously rethink its position on committing funds for priority public health programmes like AIDS,” JVR Rao, former head of NACO and health secretary, also pointed.