DEVELOPMENT BULLETIN-INDIA: HIV/AIDS Prompts Scramble for Aid

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Dev Raj

NEW DELHI, May 30 1998 (IPS) - The promise of a 200 million dollar World Bank package to fight the galloping spread of HIV/AIDS in India has prompted non-government organisations (NGOs) to scramble for a piece of the action.

“We expect to get 200 million dollars for a five-year period starting next year,” said Prasada Rao, project director at the National AIDS Control Organisation (NACO) through which the money is routed to State AIDS Control cells.

At least 40 percent of the World Bank money is earmarked for NGOs to be selected by the State Cells but most of them are ill- equipped for the job of evaluation entrusted to them, say NACO officials.

In Delhi state, where NACO has been directly funding and training NGOs for more than five years with World Bank funds, several ongoing projects have come to a standstill as a result of the new policy which stops direct sponsoring of NGOs by NACO.

“The policy could have been done in a phased out manner rather than abruptly so as not to affect ongoing projects by established NGOs,” Rao said.

One result of the new policy has been the mushroom growth in Delhi of NGOs with little background of the complexities involved in handling a project to contain HIV, but anxious to fill in slots as established NGOs close shop.

Invitations sent to three new NGOs funded by the Delhi State AIDS Control officer for a recent workshop resulted in two of them coming back stamped “addressee unknown”, said Neelam Kapoor who handles Information, Education and Counseling (IEC) at NACO.

NACO’s policy has been to fund NGOs already established in community development projects and retrain them for anti-HIV projects because of the sensitivity of the subject and the disinclination of people to discuss issues that relate to sex.

For example, said Kapoor, NACO readily funded an awareness and counseling programme run by the the Joint Women’s Programme (JWP) which had gained the confidence of sex-wrkers in Delhi through years of work among them.

Another NGO funded by NACO called ‘Drishtikon’, has done extensive work collecting data on the prevalence of Sexually Transmitted Diseases (STD).

Said Dr. Sushma Sengupta, director of Drishtikon, “We were suddenly asked to route our correspondence to the State AIDS Control Officer and to fill up forms which had been left over from some other project.”

Worse, according to Dr. Sengupta, the local officials demand a 15 percent cut under the tale. “When we refused to pay our projects were stopped,” she said.

At the prestigious All-India Institute of Medical sciences (AIIMS), Dr. Shankar Choudhury lamented the new policy which has forced several leading NGOs like Drishtikon to stop their projects pending alternate funding.

Dr. Choudhury who is assistant professor at the Department of Community Medicine at AIIMS and co-ordinator of its NGO-AIDS group set up soon after the disease surfaced in India ten years ago, said it is difficult to replace a trained NGO.

“We would like to see the Delhi AIDS cell grow into a model for the rest of the country but it is plagued by inefficiency that results from a bureaucratic approach and the frequent transfer officials,” he said.

Dr. Choudhury pointed to the fact that there have been four different State AIDS Control Officers in Delhi over the last one year as an example of the kind of ineptitude which, he says, spells disaster.

“The prevalence of HIV is doubling each year in India and you cannot approach it in the slow laid back way that you would a malaria programme — projections are that HIV is going to be tremendous burden on the health system unless everybody acts with sense of urgency right now,” he said.

India already has recorded more than 4,000 cases of full- blown AIDS while there have been more than 50,000 infections resulting in a sero-positivity rate of 18.0 per thousand. Since the age group of infected is 15-49, various demographic ratios are bound to be adversely affected, according to NACO estimates.

According to Dr. Choudhury training is indispensable to the state cells including the one in Delhi if they are to sensitise NGOs planning to deal with high-risk groups like sex workers or handle family problems arising out of HIV infections.

Barring western Maharashtra and southern Tamil Nadu, no other state has so far been able to establish an NGO advisor as stipulated by national policy and each state has its own unique problems,” Kapoor said.

According to Dr. Choudhury, broadly, “Indian society is hostile to vulnerable groups like hmosexuals and sexual relations outside marriage and NGOs dealing with HIV will obviously need to overcome such attitudes.”

Dr. Choudhury said the most important thing for the Delhi State AIDS Cell to do is to call a meeting of all the NGOs now working in the field and assess their relative strengths. “It is important for each one to know what the other is doing.”

Concurring with Dr. Choudhury is Cedric Fernandez, coordinator of the NGO ‘Sahara’ or help. “If there is going to be a real community movement against HIV it will have to start with a coming together of the NGOs,” he said.

Sahara, which is funded by the EU, runs the well-known, 16- bed, ‘Michael’s Care Home’, for HIV-infected people. The home has been such a success that Sahara has plans for three more.

According to Fernadez there is room for every kind of NGO and there is no shortage of funds whether it is World Bank money routed through NACO or from other funding agencies such as SIDA and USAID.

“What is important is for the people who run NGOs to remember what they are in it for — community service rather than a means to make money,” he said.