The Country and the State of Maharashtra have responded to the great challenge
of the HIV/AIDS epidemic, which is tending to eclipse a generation of the State.
The three societies under the Govt. viz.- Maharashtra State AIDS Control Society
(MSACS), Mumbai District AIDS Control Society (MDACS) and AVERT are heading
towards attainment of major goals of bringing about a behavior change in the
population and also to care for the patients who are HIV positive and are facing
the threat of getting into an immuno compromised state with full blown AIDS
Maharashtra has the highest rate of urbanization i.e. 42%, major national
highways pass through the state, it has a high rate of migrant and floating
population, there exists a well established sex industry in the state and industrialization
leading to availability of cash money in the hands of industrial workers. The
bed occupancy in many hospitals due to HIV positive persons has been as high
as 25% to 30%, the ANC (Antenatal cases) prevalence is around 1% the HIV prevalence
in STD clinics is 10.4%. There are 216748 registered HIV positive persons in
the state today and an estimated figure of 8,51,420 people living with HIV
/ AIDS. The total number of AIDS Cases is 47,386 and those who have died is
Nevertheless, the state has achieved many of its goals.
||The ANC clinic HIV positivity has decreased from
1.25 to 0.88 %.
||The HIV positivity rate in people attending the
STD clinics has come down from 18 in 1998 to 10.4 in 2005.
||Seropositivty among voluntary blood donors has
come down from 1.35 to 0.66.
Most of these goals have been achieved through various programmes
implemented like the STD control programme, targeted intervention,
condom promotion, Information Education Communication strategy,
blood safety, Family health awareness Campaign, APEP, VCTC, PPTCT
programme, Drop in Centres, Community Care Centres and others.
journals have been started by the societies.
“Nirdhar” (Determination) & “Yes –
We dare to Care”, are two great ventures which have come
up due to devotion, hard work and concentrated efforts of all the
Maharashtra is 2nd largest state in India with population of 100 million and
area of 3.08 lacs Sq. Km. The State has always remained on forefront in the
world in health care delivery with a very well knit rural and urban infrastructure.
The infrastructure fulfills the norms prescribed by Government of India under
model health plan. A comprehensive package of promotive, curative and rehabilitative
services are being provided through vast network of rural and urban infrastructure.
The first AIDS case was reported from Mumbai in 1986. An implementation of
an effective HIV services programme in the state resulted in better
understanding of epidemiological scenario in the state. The HIV
infection is not restricted to the core groups in the state but
has spread into bridge as well as low risk operation. Few cities
in the state have already entered into 3 phases of the epidemic.
It is now evident that spread of HIV in Maharashtra is not restricted
to high risk behaviour individual, urban cities but it has established
its roots in low risk population as well as distant rural area of
The Sentinel Surveillance 2005 shows that sero positivity in high-risk
group has gone up from 7.6% in 2002 to 10.4% in 2005. However,
positivity in low risk (ANC cases) has dropped from 1.25% in 2002
to 0.88% in 2005. There is no statistical significant increase
decrease in HIV prevalence. Therefore strengthening comprehensive,
well co-ordinate HIV prevention activities involving NGOs, CBOs
and the community in general and evolving care and support activities
to HIV affected individuals and families are crucial issues.
2nd phase of AIDS Control Programme is built on experience gained
in its implementation during the 1st phase. It has consolidated
achievements made so far
and has formulated effective, people friendly strategy for controlling
the prevalence and reducing the HIV infection rates in Maharashtra.
The project purpose to stabilize current HIV prevalence by 2003
and further reduce HIV incidence among high risk and low risk
individuals. Adopting approach of formation of society resulted
in speeding of the implementation of the programmes. The strategy
adopted a mission mode approach for focusing on effective intervention
in high-risk individuals.
Low risk behaviour groups to practice healthy and safe sex, strengthening
and operationalising STI clinics, ensuring blood safety by strengthening
and modernizing blood banks, trengthening database for better planning,
emphasizing integration with RCH and Tuberculosis control programme.
Reducing impact of HIV especially on children and promoting innovative
scheme like PPTCT programme, generating the feeling of ownership
among various sectors, mobilizing support of large number of NGOs
and CBOs for broadened community initiatives and finally converting
this programme into mass awareness and safe health movement.
effectively manage and implement the 2nd phase State AIDS Control
Society was responsible for project management which was started
by Blood Transfusion
Council and close liaison and co-ordination between MDACS and USAID assisted
AVERT Society to avoid duplication of activities and funding it. The activities,
which were implemented, have been evaluated concurrently and terminally through
The health care delivery system of India with all its emissaries starting from
the policy makers, administrators, consultants, tertiary hospital staff,
district hospital staff to the staff in the remotest primary health centre
has undertaken enormous efforts during the past decade to tackle the problem
of HIV / AIDS in the country.
It was in September 1992 that the Govt. of India started and launched the
first phase of National AIDS Control Project. It was a five years
project, named “National AIDS Control Project (NACP)”
a hundred percent centrally sponsored scheme in all the States and
Union Territories. With the first and the prime initiative taken
by the Prime Minister and labeling. HIV / AIDS as the most important
public health problem, the project got a considerable boost and
began its function with the main aims as
||To slow the spread of HIV
||To decrease morbidity and mortality associated
with HIV infection
||To minimize socio economic impact resulting from
The Phase I project was continued upto 31st March 99.
Soon after the Govt. of India, Ministry of Health and Family Welfare through
National AIDS Control Organisation (NACO), accorded sanction to the launching
of the phase II programme for Preventions and Control of AIDS in India with
assistance from World Bank.
The main aims & objectives of the phase II programme are:
1) Shift the focus from raising awareness to changing behaviour through interventions,
particularly for groups at high risk of contracting and spreading HIV;
2) To support decentralization of service delivery to the States and Municipalities
and a new facilitating role for NACO. Program delivery would be flexible, evidence
based, participatory and rely on local programme implementation plans; to protect
human rights by encouraging voluntary counseling and testing and discouraging
3) To support structured and evidence based annual reviews and ongoing operational
4) To encourage management reforms, such as better managed State level AIDS
Control Societies and improved drugs and equipment procurement practices. These
reforms are proposed with a view to bring about a sense of ‘ownership’ of
the programme among the states, Municipal Corporations, NGOs and other implementing