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

NGOs and CBOs. In addition, the core transaction between NACO and the implementers (SMOs,NGOs and CBOs) has shifted from the early surveillance initiatives, to information andeducation, to condom distribution and more recently to behaviour change — to the distinctivecharacteristics of these core transactions we refer to as transaction particulars. The change in thegovernance structure and the transaction particulars should have been accompanied by thedevelopment or acquisition of a new set of capabilities by NACO (Madhok, 2002). On this wefocus next.Transaction particularsHIV/AIDs-related policies are driven by the projections of spread and mortality in agiven population. Therefore it is important to assess the validity of such projections. In India,estimations by the US‘s National Intelligence Council (National Intelligence Council, :4)concluded that ―India is likely to have 20 to 25 million [HIV/AIDS cases] by 2010—the highestestimate for any country‖. GOI did not have a good system of its own to question these estimates,and these estimates put pressure on the GOI to act. In response, NACO created more than 1,000sentinel sites in the country, most of them antenatal clinics which test blood every month or twomonths in a year of anyone who visits that clinic; and, initiated a population-based nationallyrepresentative National Family Health Survey (NFHS-3) in 2005-2006 to measure HIVprevalence. These activities proved the estimates were much lower. The surveillance also madeclear two distinctive scenarios. The first one corresponds to the north-eastern states (e.g.Manipur) where the epidemic is driven by drug injection and where HIV prevalence has beenbetween 50 to 70 percent since the mid 1990s. In other states (e.g. Maharashtra and Tamil Nadu)the epidemic is driven by commercial sex. In these states there has not been a significant drop inHIV prevalence among sex workers (MAP, 2004).The surveillance findings also convinced NACO the importance to commit to makingcondoms accessible to the general population especially among the high risk groups. For this,NACO relied on SMOs and NGOs during the NACP-II phase. NACO met with success in states