IAPRO International Aids Prevention and Research Organisation

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INTERNATIONAL AIDS PREVENTION & RESEARCH ORGANIZATION (IAPRO), INDIA, is a REGIONAL ORGANIZATION which deals with COMPREHENSIVE HIV/AIDS, cancer, TUBERCULOSIS ACTIVITIES AND all viral infections

Rationale
The state of Andhra Pradesh consistently recording more than one percent zero prevalence among anti natal women and more than 5% among STI patients, and thus UNAIDS has declared that Andhra Pradesh is in a generalized epidemic stage. Andhra Pradesh also is an endemic state for tuberculosis as well as malaria.

The activities to control tuberculosis and malaria are in operation since 4 to 5 decades in this state. The HIV/AIDS control activities were initiated in 1992 and picked up the momentum since 1998. Andhra Pradesh with eighty two million populations is too big terrain for government alone to implement the activities. Hence a private public mix is the need of the hour.

The national AIDS control organization is implementing its activities with two goals.

a) To achieve Zero rate of spread of HIV by 2015

b) To reduce mortality, morbidity due to HIV to the lowest minimum by gearing of the existing health infrastructure.

Our organization (IAPRO) is functioning with the state disease controlling societies – HIV/AIDS, Tuberculosis, Malaria - to achieve the country’s overall goal through regional participation. IAPRO being a registered civil society working closely with the common man and grass root level health functionaries especially in the remote, inaccessible, rural and tribal areas of Andhra Pradesh since 1995 . The aims and objects of IAPRO are in complement to the national plans. Being an NGO it can voice the common man suffering and take the program benefits to the needy masses avoiding redtapism. Government agencies alone cannot achieve a comprehensive aims of the country.

CCM endorsement details for applications from Regional organization

A.P State TB Control society
A.P State AIDS Control society
A.P State Health Services

 

National Program Context and Gap Analysis for this Component 
The first case of AIDS was reported in 1986 in Andhra Pradesh. Since then sporadic focused screening of men and women of high risk category at various geographical sites in the state has revealed a progressive increase in the epidemic. Since 1998 government has initiated sentinel surveillance on regular basis at all urban areas which were extended to the rural area since 2003 the survey covered population, accessing governmental and its supported sentinel surveillance sites.

By 2004 the trends and analysis of surveillance findings revealed that in Andhra Pradesh HIV has spread across the community apart from the sex worker and their clients in both urban and rural areas.

Affected Age
15 to 29 year old women, 15 to 45 year old men are the most commonly affected age group. There is a progressive increase in under 15 age group, inspire of a reasonably affective PPTCT program.

There is no facility to monitor HIV drug resistance in this state. The clinicians and the national ART program results are showing that the problem is ascending.

Health Systems, Disease-Control initiatives and Broader Development Frameworks

In The State Of Andhra Pradesh the Health System Is Headed By Minister Health

The health secretariat is headed by principal secretary for health, medical and family welfare assisted by other bureaucrats.

The Andhra Pradesh Medical and Health services functions through health secretariat and consists of Director of Health, Director of Medical Education, Commissioner Vaidhya Vidhana Parishath,senior doctors are directors and Commissioner Family Welfare and Project Director AIDS Control Society are headed by I.A.S officers.

To control HIV spread and to offer comprehensive services to PLWHA’s, Andhra Pradesh Medical and Health Services is offering ART at 3 centers, VCT at 102 centers, PPTCT at 37 centers, Care and support at 18 centers. All teaching and district hospitals staff were training in day to day management of several of OI’s.

In the private sector services to PLWHA’s were offered by all corporate as well as Andhra Pradesh nursing homes association (membership of 1240 nursing homes). IMA is also training all its members regularly. Railways, defense, ESI, RTC, Coalfields, and TCI are also offering services.

Among NGO’s – international (AVAHAN, PSI, Alliance India, CDC, PCI) National (Freedom foundation, LEPRA, IAPRO, CHAI, St.Paul’s trust, Cheli, etc.) are also offering services either independently or through private public mix.

Currently Government of Andhra Pradesh through its Strategic State AIDS Control Society is Implementing NACP Phase II Activities in the State and Encomphasis IEC, Low-cost AIDS care, blood safety, PPTCT, STI services through both governmental and non governmental agencies and trying to achieve the national goals.

The stigma associated with HIV/AIDS and tuberculosis is inhibiting the people in accessing the services at early stages. This is getting catapulted by further decreasing the ability to do work, increasing the sickness absenteeism, thus a vicious cycle being established especially in the rural and tribal areas, dampening the poverty reduction strategies of the government. Even under 3/5 initiative it was estimated that 10% of the estimated 5.1 lakh of PLWHA may require ART. But in reality only 2% of the estimated 10% are receiving ART under government setup. If we combine this figure with that off people accessing ART in private and corporate setups the figure may reach up to 3%

As per the NACO approved low cost AIDS care strategy.

IAPRO as a registered NGO is working with this down trodden group in preventing HIV/AIDS among these in the last decade. Keeping the lesson learned and an experience gained by the NGO it has selected goals, objectives and service delivery area. At the end of the project IAPRO is visualizing a more vibrant community which is capable of taking care of themselves in avoiding HIV/TB and to access the system for early diagnosis and treatment in the unfortunate event of succumbing to them

The key problems and gaps identified by the NACP II in Andhra Pradesh is unequal distribution of service provision and in spite of good knowledge and awareness lack of change in behavior among the sexually active age group. IAPRO has designed this proposal to precisely address this to problem areas. There by meeting the national goal of 100% awareness and change in behavior to a responsible way and also to address the mall distribution of service provision in this difficult Naxalite infested drought prone, continuously devastated by famine terrain

Program and financial management
Dr. B. Ranjith is a qualified medical professional with a specialized advanced training in HIV/AIDS management at University of Illinois, USA. He is successfully managing a ten bedded exclusive HIV caring hospital at Hyderabad and 50 bedded hospital at Mangalpally R.R.Dist. As a chairman of IAPRO he has successfully handled both public and private funds without any remarks to the satisfaction of the donors with the up to date of accounts.

Monitoring and Evaluation (M&E)
The monitoring and evaluation activity of the government sector as well as the data collected is a subject of criticism and disbelief by non government sectors. The only way to address this issue is to validate the government finding to a third party observation such as NGO’s, after ensuring data collection process proper and valid. As IAPRO operates in most in hospitable terrains the data from these areas will strengthen the M and E plans of state and central and may help to fill the gaps in the existing data collection system.

Procurement and Supply Management
IAPRO do not procure and supply drugs. It basically prescribes the drugs to PLWHA and arranges for financial subsidy through philanthropic associations.

The basic equipment for IAPRO was procured from the market at the time of its establishment (1995). IAPRO was also ran a drop-in care center for AP state AIDS control society for which drugs were procured and supply by society.

Technical Assistance and Capacity-Building

1. To cover larger population IAPRO need more number of master trainers as well needs to create regional trainers/councilors to address this constraint IAPRO is proposing to train nine master trainers to cover nine districts and 36 regional trainers for nine districts

2. Transporting the patients and /or their sputum’s for examination to nearest Microscopy centers requires community volunteers as these areas do not have adequate health staff. Hence IAPRO proposing to identify and train minimum educated tribal/rural youth to act as transporters as well as dot providers for a minimum honorarium. IAPRO estimates to deploy 300 such cadre in nine districts.

3. To cover larger area sufficient vehicle should be there. IAPRO proposes to purchase to all weather cruisers.

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