National AIDS Control Organisation

National AIDS Control Organisation
Name	National AIDS Control Organisation
Abbreviation	NACO
Formation	1992
Type	Government agency
Purpose	Prevention and control of HIV/AIDS
Headquarters	New Delhi
Region served	India
Leader title	Director
Parent organization	Ministry of Health and Family Welfare

National AIDS Control Organisation is an Indian agency responsible for formulating policy and implementing programs for prevention and control of HIV/AIDS in India. It operates under the Ministry of Health and Family Welfare and coordinates with state-level bodies, international agencies, and civil society to deliver HIV testing, antiretroviral therapy distribution, and public health campaigns. NACO's work intersects with national initiatives such as the National Health Mission and global efforts by the World Health Organization and the Joint United Nations Programme on HIV/AIDS.

History

NACO was established in 1992 in response to rising concern about HIV cases linked to the global HIV/AIDS pandemic and international calls for national responses following the World Summit for Children and evolving public health frameworks. Early phases drew on technical guidance from the World Bank and policy models used in the United States and United Kingdom, adapting interventions from programs like the Ryan White HIV/AIDS Program and strategies promoted by the UNAIDS Secretariat. Major milestones include the launch of the National AIDS Control Programme phases NACP I–IV, policy shifts influenced by events such as the Delhi Declaration on HIV/AIDS and court rulings from the Supreme Court of India on access to medicines and human rights for people living with HIV.

Organization and Governance

NACO functions as a national nodal agency under the Ministry of Health and Family Welfare and collaborates with state AIDS control societies, municipal bodies such as the Municipal Corporation of Delhi, and institutions like the All India Institute of Medical Sciences. Governance structures include a governing board informed by stakeholders from bodies like the Indian Council of Medical Research, representatives of affected communities and legal experts who have appeared before the Supreme Court of India on public health litigation. Technical advisory inputs often come from panels involving the National Institute of Virology, academic departments at All India Institute of Medical Sciences, New Delhi and policy units linked to the Planning Commission of India and later the NITI Aayog.

Programs and Strategies

NACO implements multi-pronged strategies that encompass targeted interventions for key populations, large-scale communication campaigns, and clinical services. Targeted interventions engage networks identified in reports from the National Commission for Protection of Child Rights and community groups like the Durbar Mahila Samanwaya Committee and Humsafar Trust. Clinical programs include antiretroviral therapy rollout coordinated with tertiary hospitals such as King Edward Memorial Hospital, integrated counseling and testing centres modelled on protocols from the World Health Organization, and prevention of mother-to-child transmission services linked to maternal health initiatives like the Janani Suraksha Yojana. Behavioural change communication drew on mass media partnerships with broadcasters such as Doordarshan and All India Radio and public advocacy by figures who have supported HIV awareness campaigns.

Funding and Partnerships

Finance for NACO projects has combined central budget allocations from the Ministry of Finance, multilateral funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria, and bilateral assistance from agencies including the United States Agency for International Development and the Department for International Development (United Kingdom). Partnerships extend to civil society organizations like Médecins Sans Frontières and academic collaborations with institutions such as the National Institute of Epidemiology and international research centres like the London School of Hygiene & Tropical Medicine. Procurement and supply chain collaborations have involved logistical agencies and state procurement units influenced by rulings from tribunals such as the Central Administrative Tribunal.

Monitoring, Evaluation, and Research

Surveillance and evaluation systems draw on data from the annual HIV Sentinel Surveillance, household surveys such as the National Family Health Survey, and program monitoring frameworks aligned with indicators used by UNAIDS and the World Health Organization. Research partnerships include work with the Indian Council of Medical Research, the National AIDS Research Institute, and collaborations with universities like Jawaharlal Nehru University and University of Delhi on epidemiological modelling and operational research. Findings have informed policy shifts presented at forums including the Conference on Retroviruses and Opportunistic Infections and policy reviews by committees appointed by the Ministry of Health and Family Welfare.

Criticisms and Challenges

NACO has faced critiques over resource allocation, service reach in rural districts documented by the Comptroller and Auditor General of India, and tensions highlighted in litigation before the Supreme Court of India concerning access to generic antiretroviral drugs. Challenges include addressing stigma reported by advocacy groups such as the Naz Foundation, integrating services with state health systems like those in Uttar Pradesh and Bihar, and sustaining financing amid changes in multilateral funding priorities by entities like the Global Fund. Operational hurdles also involve supply-chain disruptions noted in audits by the Controller General of Accounts and workforce shortages discussed in reviews by the National Health Systems Resource Centre.

Category:Health organisations based in India Category:HIV/AIDS in India