Index of Paper Presentations for the Parallel Sessions - Academy of ...

different levels of government to provide care, support and treatment of the disease; anddeveloping a nation-wide strategic medical treatment information management system. There arefour fundamental differences between NACP-II and NACP-IIII. First, the latter was developedunder an open consultation among experts and key stakeholders. Second, NACO decided torestrict to few funding agencies to have more control and a more consistent strategy acrossprojects and initiatives. Third, the target population is narrower to include only commercial sexworkers, men having sex with men, transgender and injecting drug users. Finally, NACP-III isgiving greater importance to condom promotion.At the core of the NACO‘s strategy is the access to condoms. There are three waysthrough which, the general population but mainly the target group, could access condoms: freedistribution program in all public health facilities, at cost in the open market, and through SMOs,as a senior government official put it ―people generally cannot afford the expensivecontraceptives which were available in the open market. So the government of India used tosubsidize the contraceptives…[and they were] made available through normal shops in thevillages‖. In this regard, NACO enlisted the help of many SMOs to ensure availability ofcondoms across the country.However, there were signs (e.g. uncoordinated national plans, condom‘s brand drivencompetition among SMOs) that NACO‘s strategy and implementation created conflict andunnecessary tensions among key stakeholders in detriment of the main objective. For example, atthe time NACO decided to strongly promote condoms to tackle HIV/AIDS; there was already asister organization, the National Rural Health Mission (NRHM), that promoted condoms as afamily planning option. While both organizations work under the Ministry of Health and FamilyWelfare, they work independently. The result was not only an inefficient use of resources but alsoconfusion with two different messages to promote condoms.NACO‘s approach to increase access to condoms by subsidizing them and empoweringSMOs to promote and distribute has made small cities and villages less attractive; unless SMOs