Support to the National Programme on HIV/AIDS and Scaling up Access to HIV Prevention, Treatment and Care (SNPHCAHPTC)
What is the project about
Most of the estimated 70,000 Nepalis who are HIV-positive are from the most at-risk groups. Whilst only an estimated 0.49% of all 15 to 49 year olds are HIV-positive, the prevalence is well over 5% amongst injecting drug users and over 1.5% amongst female sex workers, men who have sex with men and labour migrants, with much higher rates found in some areas. In terms of absolute numbers, Nepalâ€™s 1.5 to 2 million labour migrants account for the majority (42%) of HIV-positive people followed by the clients of sex workers (15 percent) and injecting drug users (10 percent). Until now infection has mostly been transmitted by injecting drugs and unprotected sex amongst these and other at-risk groups.
While recent data indicates a stabilising trend in the rate of infection, and a downward trend among several high-risk groups, a number of large challenges remain. A large proportion of the men who purchase sex are married, making them potential conduits for HIV to bridge to the general population. Overall, widespread poverty, low levels of education, illiteracy, gender inequalities and stigma and discrimination compound the ill-effects of being HIV-positive. Unsafe sex and drug injection practices, civil conflict, internal and external mobility, and limited access to health care multiply the difficulties of addressing HIV/AIDS. Moreover, existing care and support services are overwhelmed as increasing numbers of HIV-infected persons become sick with AIDS.
Since 2005, UNDP has played a key role in supporting the implementation of the National HIV/AIDS Programme. It administers donor funding and is responsible for the overall management and implementation of the $22.6 million support programme. The $17 million of DFID funding is going to roll out a comprehensive HIV/AIDS prevention and care programme for migrants, injecting drug users, men who have sex with men and all people living with HIV/AIDS. The $5 million from the Global Fund to Fight AIDS, TB and Malaria is being used to provide a safer blood supply system, to procure drugs and other health commodities and to support the HIV/AIDS and STI Control Board.
What have we accomplished so far
Reaching the most at-risk populations Over one million migrants, injecting drug users and men who have sex with men have been reached to prevent them from contracting the disease and to inform them what to do if they become infected. The support to large-scale behaviour-change communication, peer education, community sensitisation and advocacy initiatives, plus the setting up of many drop-in and information centres, has limited the spread of the disease. The programme has also supported the testing of 33,000 people for HIV/AIDS, the treatment of 41,000 at-risk people for sexually transmitted infections and the distribution of over five million condoms and one million lubricants to at-risk people.
Strengthening institutional capacity Considerable support has gone to strengthening the HIV/AIDS and STI Control Board, the Government agency responsible for coordinating HIV/AIDS activities in Nepal. This is building up the capacity of this agency so as it can take over the responsibilities for administering international assistance to HIV/AIDS and for implementing the national programme. The programme is also working to strengthen the ability of civil society to provide support services. In 2007, 55% of the $7.3 million of programme expenditure was channelled through 59 NGOs and 61 community organisations, mainly by providing them with grants and training to conduct community home-based care, and provide referral services for anti-retroviral treatment, immunity counts and the management of opportunistic infections.
Livelihoods support Work has begun on the crucial task of supporting the livelihoods of people affected by HIV/AIDS so as they can live in dignity. So far 409 infected and affected persons have been trained to start up small businesses, with further support helping some of them establish businesses.
At the beginning of 2009 Nepal received further large funding from the Global Fund. This is being managed by UNDP under the separate initiative, Scaling up Access to HIV Prevention, Treatment and Care. This aims to strengthen and expand voluntary counselling and testing services, strengthen the civil society response to the disease and expand the availability of anti-retroviral treatment. It also seeks to improve the availability of information on the disease, strengthen district AIDS coordination committees and support the Government's overall response.
Who Finances it?
|The Global Fund
|Total funded budget||$6.7 million|
Delivery in previous fiscal year
Importance of these projects towards achieving the MDGs and consolidating peace
UNDP's support to the national programme has played a crucial role in reducing the rates of infections among the at-risk groups to put Nepal on-target to achieve MDG 6 of having halted by 2015, and begun to reverse, the spread of HIV/AIDS. The two projects are crucial to preventing an epidemic from developing in the general population, which could undermine development across all the MDGs, as has happened in some African countries.