World AIDS Day 2009-10 : Missing the target?
- Part 2 -

By Deben Sharma *

Therefore, 'Universal access and Human rights' are also greater concerns for parents in those families and communities who live with PLHIV. Involving the affected people in the families and communities more actively and in greater ways in all programs and decision-making by targeting resources should effectively contribute to overcoming issues of HIV and AIDS in the state.

Since more than the nature of disease the associated stigma and discrimination of the infected people are the major issues advocacy is the key to success in addressing HIV and AIDS in our society. By practice we also know that advocacy requires aware and able bodies to run around and reach out all levels to bring results.

Large numbers of infected people in general population are poor, less aware and weak except for those in leadership levels most of whom are also engaged small to big project responsibilities. Majority rests are struggling for their day-to-day survival at the receiving ends.

For them getting whatever available is more important than raising questions that might stop the next supply. Moreover, PLHIV networks have leadership, serious governance problems and conflicts among themselves which further hinder their performance as watch-dog or advocates of the issues.

For all these reasons left to PLHIV, MACS and some NGOs alone, all of whom seem to have settled in their own comfort zones, it is likely that we may end up losing control over our own situation or continue to expose our community to HIV and AIDS for longer time than what is actually necessary.

Like in a war economy many powerful and influential actors derive benefits from continuation of the war there is also a danger HIV and AIDS programming that many actors/ stakeholders may also be more interested in continuation of the problem rather than halting and reversing pandemic.

The goal of NACP-III programs starting from 2006 and ending in 2011 is precisely 'halting and reversing' spread of HIV and AIDS. It is anybody's guess where the state stands today 2 years before project ends!

But for all the responsible citizens who want to have their progeny continue to survive healthy, progress and advance through generations as distinctive identity, community, clans and families they need to reach out to PLHIV networks/ NGOs, join hands with civil society organizations to address the issues of 'access' and also larger issues of and needs for 'awareness' and 'prevention' for general population together over a common platform.

In trying to be sensitive to the issues of stigma and discrimination the HIV and AIDS programming in the state seems to have gone too exclusively targeted in nature that average people left unaware. Any program intervention that excludes the general community from PLHIV community by exclusively targeting them or organizing while missing the general population can prolong the problem.

Discrimination of families and communities for that matter the general population in HIV and AIDS programming will not help address the issues of the 'stigma and discrimination' which actually complicated management of the disease.

There thus, arise some urgency for civil society organizations to actively get involve and monitor the performance of all the 3 sectors; PLHIV Network, MACS and NGOs involved in addressing HIV and AIDS issues in the state and where necessary lend supports in advocacies on issues of access and human rights in the larger interests of the society.

Should we than be have a realistic assessment of HIV and AIDS situation and develop our own state level theme based on the priority issues of all concerns; the different key population and marginalized sections in PLHIV community and the concerns of affected general populace while also observing the day on global theme such as "Universal Access and Human Rights"?

Can we also walk an extra mile to modify opportunities and redefine objective or for that matter redesign projects based on our own situation and needs rather than just running a given program to meet the targets that was set years before and / or doing programs under pressures before the budget expires.

If the government's statistics are any indicator then we have a situation of alarming proportion at the present rate of prevalence in the state. The spread is among the general population. HIV is no more confined within the key population or high risk groups. IDU related spread of HIV has been scaled down to a minimal and manageable (18% MACS Epidem data, Sept 2009) level after a decade of intervention.

This is a great achievement for the state govt and NGOs that we need to celebrate. The question now is how do we have HIV and AIDS programming the state focus local priority issues and targeting resources in creating effective awareness among the people and facilitate evolving community based prevention and access strategies and mechanisms by setting targets for reversing the increasing trends of HIV prevalence in general population in the communities.

With the goal of "halting and reversing" spread of HIV and AIDS NACP-III must facilitate and promote active roles and participation of affected families, clan, tribe and Leikai to development objectives at their levels. Head of each family, each clan (Sagei), and Leikai through the community organizations (Singlup, Youth Club and Meirapaibi organization) must be actively involved and supported in setting targets for reversal at their levels and set objectives for care, treatment and supports for infected members at their levels.

It is the local community, families and clans who must be more interested to take charge of addressing the issues of HIV and AIDS in the state. And it is in this initiative the State AIDS Control Society must effectively respond to the facilitation roles shifting from project paradigm to program paradigm as it is well reflected in the NACP-III.

We must look forward to observing the 2010 World AIDS Day with all these concerns taken together on board on a common platform set our own targets to achieve the goals of "halting and reversing" at grass root levels.

(Concluded)