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The National AIDS Control Organisation (NACO), established in 1992 is a division of India's Ministry of Health and Family Welfare that provides leadership to HIV/AIDS control programme in India through 35 HIV/AIDS Prevention and Control Societies, and is "the nodal organisation for formulation of policy and implementation of programs for prevention and control of HIV/AIDS in India.".

NACO also undertakes HIV estimations biennially(every 2 year) in collaboration with the Indian Council of Medical Research (ICMR) – National Institute of Medical Statistics (NIMS). The first round of HIV estimation in India was done in 1998, while the last round was done in 2015.

In 2010, NACO approved the TeachAIDS curriculum for use in India, an innovation which represented the first time that HIV/AIDS education could be provided in a curriculum which did not need to be coupled with sex education.

In 2012, National AIDS Control Organisation, along with other 16 organisations working on HIV/AIDS, ran an event "Hijra Habba" under the programme of “Pehchan”. The event witnessed more than a 100 representatives of the Transgender and the Hijra community from 17 states, interacting with members of the government, NGOs and Civil Society.

= Objective: = NACO intends to reverse the stigma against HIV by offering dignified and accessible care to everyone affected by it in India. NACO works with religious groups, NGOs, female-help groups, local awareness projects, and public networks to reach out to as many people struggling with HIV as they can. They believe that HIV in India can be contained. NACO also specializes in sex education that will help protect against the spread of HIV through unsafe sex practices. They bring awareness from a district to a national level through their various programs in place. They base their outreach on the fabrication of strategic responses and work diligently towards containing the epidemic in India. They also are working towards bringing Integrated Counselling and Testing Centers, known as ICTCs, to places in India where HIV is present. Their main vision is to have an India where everyone is aware of the HIV/AIDS risk and an India where those who are affected with HIV and AIDS can receive proper testing and treatment. Currently, they have been focusing on spreading information to the public- they spend a lot of their efforts in education in especially rural and marginalized communities. On their website, their visions are stated in more detail with the main aim being eradication of the disease through educating the public. (National AIDS Control Organization, India, 1992).

= History: = This nationally funded organization was created in order to address the HIV/AIDS epidemic in India. After much research, NACO was created in India in response to the spike in HIV/AIDS not only in marginalized communities but even in the general public. They were created also to provide sex education to the public. Sex education is a large part in preventing sexual disease like AIDS, and in India, sex education is limited given the conservative nature of the schooling system present. NACO was actually created alongside another program known as National AIDS Control Programme (NACP). The NACP focused more on prevention and control of the epidemic, whereas NACO was a more generalized program. NACO has also been attempting to create a vaccine for HIV and AIDS since 2001 by partnering with the International AIDS Vaccine Initiative. NACO is aware that if any country is going to benefit from the existence of such a vaccine, it is India- this is because India has the highest prevalence of HIV and AIDS alongside China. There is also a strong concentration of HIV and AIDS in specific "hot spots" of India which means that there needs to be more focus entailed in those portions of India by the production of such a vaccine. (Lo, C.Y, 135). NACO gets most of its funding either from the national bank or from the World Bank. When NACO was first established, it was an independent program, however of recent, a new department has opened up that has made it a branch of the Department of AIDS Control. Their current focus is on sex education or prevention of disease through education.

= NACO's Target Population: = NACO helps a lot of the generalized public, but of late, their main focus is to decrease occurrence in hot spot areas in which AIDS and HIV is extremely prevalent. Specific states in India have more of an occurance than others such as Andhra Pradesh, Karnataka, Tamil Nadu, and Nagaland. In the Southern states of India, the prevalance of HIV and AIDS in clinic areas is as high as 22.8% of the population. (Gupta, et. al, 22). These are the areas they intend to target with their vaccine, if it gets developed, and they intend to develop on that focuses on the subtype C virus because that is the most prevalent of late. Another group that they work with is pregnant woman: if a pregnant woman is affected by HIV, they help the woman get counselling and even help her decide if she wants to have a delivery or not because sometimes it is not possible for the baby to survive or for the mother to take care of the baby after birth. Another group in specific that they assist is female sex workers. As reported by research done by AVERT, hostility towards sex workers in India is high because even though sex work is not illegal, a lot of associated activities such as running a brother is. With that said, around 1.6% of female sex workers in India were living with HIV and AIDS. This essentially meant that there is less of an opportunity for them to reach out for help- that is why NACO helps to support their needs as well through affordable treatment. In 2015, NACO published a report that stated that they reached up to 77.5% of sex workers in their highlighted areas and got them to attest to HIV prevention. By 2017, 91% of sex workers were using condoms despite having HIV or not. (HIV and AIDS in India, AVERT, 2019). Their biggest success story is in being able to get lowered infection rates of HIV in India through education. (Mamulwar, et. al., 2018).

= Obstacles: = The main obstacle with NACO is the density of the population. In a population such an India with such a dense population in which HIV and AIDS are still stigmatized, it becomes very difficult for outreach to become possible. People are reluctant sometimes, even to reach out for information and education. NACO is very aware that to combat any epidemic is to be aware of how such viruses spread and how to prevent them; this is the very intention of their workshops in wanting to bring awareness to the situation at hand. To combat the problem of reaching out to the masses, NACO attempts to work closely with hospitals. On their website, they have a document that they give to nurses on how to identify obstacles not only in refusal to cooperate but also in being able to diagnose people with HIV. In that document, it is stated that these are the possible obstacles they face in trying to treat women with HIV: the treatment may not be effective, the partner is not treated so it is recurring, they are not compliant, they are not treated correctly, they don't go to any health unit, they don't seek treatment even after diagnosis, or they are asymptomatic so they don't get diagnosed correctly. With this many obstacles, they have individualized protocols for all of these problems. But, many of the times they are still unable to get to the bottom of the situation. Then, the situation becomes about if is it even possible to completely eradicate the disease to the extent they want. (National AIDS Control Organization, India, 1992).

= Future Development: = Right now, NACO is working towards creating clinics, tests, and community outreach. These three subjects are of extreme importance to them because they want to be able to create the best effect in terms of prevention. But, they have a new program going on in which they are asking inventors to create a long-term solution to reach unreachable communities; and, they intend for this innovation to be utilized by many organizations including themselves such as NGOs, hospitals, and etc. The criteria for this project's innovation is that they should be one of the following:


 * Solutions that demonstrates reach and impact
 * Solutions that specifies the number of people tested and treated for HIV
 * Solutions that through a specific algorithm-based denominator validates behavior change
 * Solutions that are off the beaten track, daring in its premise and should clearly be differentiated from standard practices
 * Solutions that can have a potential of substantial impact on one or more steps of continuum of HIV services i.e. prevention, care, support and treatment
 * Solutions to be scalable and have measurement metrics for monitoring and evaluations
 * Solutions that provide low-cost or highly cost-effective solutions

With this project, NACO wishes to combat their obstacles as best as they can and finally come close to shutting down the stigma around HIV and AIDS in India as well. (Rethink HIV, 2019).

= Sources: =


 * 1) HIV and AIDS in India. (2019, January 18). Retrieved from https://www.avert.org/professionals/hiv-around-world/asia-pacific/india
 * 2) Gupta, I., Trivedi, M., & Kandamuthan, S. (2007). Adoption of health technologies in India: Implications for the AIDS vaccine. Los Angeles: Sage Publications.
 * 3) N. (2017). A Report on the Inaugural Ceremony of Community Based Testing (CBT) in Rajasthan(Rep.). Bhilwara: NACO.
 * 4) N. (2017). Nurse Handout, Training of Nursing Personnel to Deliver STI/RTI Services: NACO.
 * 5) Alary, M, Banandur, P, Rajaram, S. P, Thamattoor, U. K, Mainkar, M. K, Paranjape, R,  Adhikary, R, Duchesne T, Isac, S, Moses, S. (2014). Increased HIV prevention program coverage and decline in HIV prevalence among female sex workers in south India. Sexually transmitted diseases, 41(6), 380-7.
 * 6) RETHINK HIV GRAND CHALLENGE 2018. (n.d.). Retrieved from https://www.rethinkhiv.in/
 * Lo, C. Y. (2015). HIV/AIDS in China and India: Governing health security. New York, NY: Palgrave Macmillan.
 * 1) Mamulwar M, Godbole S, Bembalkar S, et al. Differing HIV vulnerability among female sex workers in a high HIV burden Indian state. PLoS One. 2018;13(2):e0192130. Published 2018 Feb 8. doi:10.1371/journal.pone.0192130
 * 2) World Aids Day On World Map stock photo. (n.d.). Retrieved from https://www.istockphoto.com/photos/world-aids-day?sort=mostpopular&mediatype=photography&phrase=world aids day