NACO meetings lack transparency and civil society participation. By Bobby Ramakant


India's national AIDS programme lacks transparency and civil society participation, said health activists of Delhi Network of people living with HIV (DNP+). Working group meetings for planning the fourth phase of India's AIDS programme (2011-2017) are being held in New Delhi. DNP+ is calling on NACO's Director General to increase transparency around the process and strengthen participation of civil society, particularly representatives of vulnerable communities, groups working on access to treatment, community based organizations and state level people living with HIV (PLHIV) networks in the working groups.
The National AIDS Control Programme Phase IV (NACP IV) plan will define the national response over the next five years. The working groups of the NACP IV focus on key policy areas including medicine procurement, stigma & discrimination, prevention, vulnerable communities, care, support and treatment .
PLHIV networks like DNP+ highlight that it is not enough to have government departments, funders and international NGOs on the table. PLHIV networks, vulnerable communities, especially sex workers, sexual minorities, injecting drug users (IDUs) and others, must feel they have an equal if not a bigger stake in the planning of HIV prevention and treatment efforts under NACP IV.
Organised by NACO in New Delhi, these working group consultations for example on care, support and treatment (2nd and 3rd May), are being conducted in secrecy while the affected community – the PLHIV networks of different regions and states including Delhi barely have any information about it.
NACO has prioritized participation for funders, international NGOs, National AIDS Research Institute (NARI) of Indian Council of Medical Research (ICMR), doctors from the public and private sector and among PLHIV networks only Indian Network for People Living with HIV (INP+). PLHIV networks and organizations involved in access to treatment issues - working regionally, at the state level and even in Delhi itself - have not been provided information regarding the process, agenda, meeting schedules and venue.
The lack of transparency in the constitution of the working groups like the one on drug procurement is a case in point. "Without the feedback from the community on stock outs or excess stocks of medicines at ART centres, how will drug procurement be reformed? But civil society has no information on the working group set up to look at drug procurement for the AIDS treatment programme. Under Section 4 of the Right to Information Act, 2005 every Public Authority including NACO is required to disclose information voluntarily," says Vikas Ahuja from DNP+.
According to the Planning Commission's Task Force on Governance, Transparency and Participation, accountability and transparency are critical elements of good governance.
"NACO is a state agency and is bound by the obligation to consult and ensure proper participation in its policy making," explains Loon Gangte of International Treatment Preparedness Coalition (ITPC) India. "Policy making that affects us should not happen without us. Our perspective, experience and expertise should not be dismissed," he adds.
DNP+ is calling for increasing transparency and strengthening participation of community based organizations and PLHIVs networks in NACO's policy making initiatives - both Technical Resource Groups (TRGs) that meet every year and the working groups for NACP IV.
The first step is transparency around the constitution of the working groups. The members, timetable, briefing documents, agendas and minutes of different working groups should be made public on the NACO website. In addition, DNP+ calls for a regional consultative process that allows even resource poor PLHIV and community based organizations to participate.

(The author is a World Health Organization (WHO) Director-General’s WNTD Awardee 2008 and writes extensively on health and development through Citizen News Service (CNS). Email:, website:

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