The Union health ministry wound down its department of AIDS control (DAC), which runs India’s five-year Rs. 14,295-crore National AIDs Control Programme-4 (NACP-4), and merged it with the department health and family welfare.
The merger is part of the Modi government’s decision to streamline work processes by raising efficiency and decreasing overlap of programmes across department and ministries.
"There is absolutely no change in the existing AIDS-control programme, only the structure has been redefined," said Union health minister Harsh Vardhan. "HIV is like any other disease – tuberculosis, malaria or vector-borne diseases - why should we have a parallel system for it under a secretary-level director-general?"
Currently, an estimated 2.39 million people in India live with HIV, which infects 0.27% of its adult population.
Dr VK Subburaj, secretary, DAC, has been transferred as secretary, National Scheduled Castes Commission this week.
"Like all other disease-control verticals, it will now be headed by an additional secretary and I will remain in charge of policy," said health secretary Lov Verma, who was secretary, AC, till February this year.
HIV activists feel the Centre’s conservatism has had a role to play. "For me, it’s a huge disappointment. There’s a taboo against sex education and condoms in this government, and now they’re playing with lives," said Abhina Aher, chair, Asia Pacific Transgender Network, and manager, India HIV/AIDS Alliance.
"What they are saying is rubbish, it’s all nonsense. I’m for condoms and sex education in schools," said Dr Vardhan. "This is a part of intra and inter-ministerial streamlining and it’s wrong to read anything else in it."
The fact is that India’s AIDS-control programme has been among its most successful, with new infection falling by 57% in over the past decade, shows UNAIDS Report 2013. Globally, new HIV infections declined by 25% in the same period.
"NACP, which is now in its fourth phase, is successful because it involved stakeholders, TB- and malaria- control programmes are a mess. It’s strength was stakeholder involvement and intensive monitoring, which may get lost if its handled by a bureaucrat handling a dozen other programmes," senior advocate Anand Grover, director, Lawyers Collective, which drafted the HIV/AIDS Bill.
"There should have been some discussion or thought given to the way ahead, but there was no discussion, nothing," says Grover.
Activists argue that what has worked is "people at most risk" — sex workers, drug users, and men who have with sex with men and transgender — leading the programme. "If you treat it like any other disease and exclude them, infection will boomerang," says Aher.
With HIV data staying under 2.5 million for over seven years, India cannot risk becoming complacent. In lowering infection, India, along with Myanmar (72%), Nepal (87%) and Thailand (63%) are among the high achievers in Asia.
"India should work harder to stay there, and not fall into the 'emerging epidemic' club, where new HIV infections have increased," says Grover.
New HIV infection risen eight-fold in Pakistan, 2.6 times in Indonesia; and more than doubled in Philippines, said UNAIDS Report 2013.