India AIDS Initiative, Assessment Example

Introduction

In the year 2003, Bill and Melinda Gates came up with this foundation; it was founded to fight against the spread of HIV/Aids. In the beginning of the project it was called the Bill and Melinda Gates Foundation but after a while it was changed to Avahan Initiative. At this time the spread of HIV in India was at an alarming rate and called for external assistance to help fight the pandemic. This was as a result of the country’s large population and the state of its economy (India is the second populous country in the world). The program has grown to become among the largest organisations fighting against HIV in India, in 2009, the organisation planned to spend over US$338 million to fight against the rapid spread of HIV/AIDS, this is by helping the infected care for their basic needs, support them with drugs (ARV and ART), creating awareness to the less informed and other services within that range (NACO, 2003).

Detailed Information about Avahan Initiative

The foundation had three main objectives in the beginning which have later broadened with the demand of other services with its area of aid. These objectives were: to build a HIV control and prevention model in India, motivate other organisations to help in the fight and replicate the idea, disseminate and foster learning within India and other Nations as well.

With it good management and donors, is has been in a position to meet all is primary objectives in its first five years. It has set deep roots in India’s six states which have a total population of over 300 million residents. In these six states, it is capable of providing prevention services for over 200,000 female sex workers, and over 60,000 men who are homosexuals. It services has also reached to the injecting-drug users who are around 20,000 together with over 5 million men who are at a risk of contacting the virus (Ghys PD, et al. 2002).

At the moment Avahan, is now trying to meet its second goal, which is to hand over the program to other bodies such as the Government of India as well as the communities it has served for all those years. The program has also done a lot in its third goal which is to disseminate learning, this is being met by coming up with helpful websites that have all the knowledge needed to fight HIV in the region, the steps that can be taken and areas where they can get assistance in case its needed. This has resulted from formation of hundred of grassroots NGOs, partner organisations, numerous peer educators and others groups aiming to meet the main goal of all this parties which is elimination of HIV in India. Newer organisations such as MDGs which have been created by the United Nations Organisation to help in the fight against HIV in the poorer countries is an organisation that has celebrated the initiatives of Avahan as its main aim is ensuring economic growth while working on the improvement of quality of life (Hickey and Mohan, 2004).

It has proven to be one organisation that has played a big role in the fight against HIV, this project describes the organisation’s initiatives and also an over view of the strategies used by the Initiative to meet it goal and end up influencing million of well wishers to help in its entire running (Hickey and Mohan, 2004).

Success and Challenges Faced By the Program

Increased funding and advocacy in the year 2003 for the treatment and care had led to HIV/AIDS prevention losing interest in different practitioners. Worldwide, it was evident that working with individuals with high risk and bridge populations in concentrated and early epidemics led to reduction of HIV overall. However, there were very few organisations willing to provide services for large populations with high risk of contracting the virus at a country or regional level. This was one of the major challenges that faced the efforts of this organisation. It was the sole Program offering services to the infected and the affected in the region  (UNAIDS, 2002).

From the report from UNAIDS of the previous year; 2002, it stated that Asia is the region that had the highest population of the infected individuals which was about 20% of the worlds total infected population. This report is one of the major reasons that led to the formation of this program despite the challenges and the funding. The reason why India was the most affected was that there was a big population of commercial sex workers together with their clients, high frequency of unprotected sex and drug abuse.

Avahan was focused in meeting the needs of the population with the high risk and bridge populations, in their geographies, with their known package of prevention. By 2006, it had touched over 83% of the overall infected population in the six states. It had formed great roots with the government, NGOs, and other organisations willing to help. In 2007, it had formed prevention programs which were in 605 towns and around 84% of the districts in the Country, these programs served over 279,000 individuals with a high risk of contracting the infection (UNAIDS, 2002).

The Funding System Effects to the Goals

The funding system did not affect the goals of the program in any way. In fact, it has gone to an extent of adding it allotment to the program in past few years from US$258 to US$338 millions. It has also helped its partners to reach their target groups in order to expand the HIV prevention services. In the resent years, it has been supplying hundred of thousand of Indians with condoms, treatment for the STIs, risk reduction counselling, and other prevention services.

Social and Cultural Considerations by The Program

In order for the program to get roots and be upheld by the target groups, there were minor cultural considerations. This was met by selecting groups of enlightened Indians and taking them for training. These were the individuals who were later in charge of the program’s target. It was put in place to ensure that their social and cultural values were not violated which otherwise would affect the goal of the program (UNAIDS, 2002).

Other Factors Contribute To the Success of the Program

The country’s cultural values and culture was one of the minor reasons leading to the success of the program. They were very friendly and willing to learn. Although some were difficult in embracing change, but with the persistent aid from the donors, it became fruitful; most of the regions with high risks have been given enough attention (Bill and Melinda Gates foundation, 2011).

Sustainability and Scalability

The project is scalable as it has worked extensively helping almost all organisations in India which have shown interest in fighting against HIV pandemic. Avahan is funding individual organisations including the government itself. This shows its efforts and reach are becoming of benefit to all sectors. Its funds are sustainable as they are from a five star company; Microsoft, which is owned by the main founder of the organisation and its carrying the project out as its community development role. This makes it sustainable and reliable too (Family Health International, 2007).

Is the project replicable?

The project has replicated, this was the third it of its main three goals. It is evident from the hundred of organisations, non-governmental organisations and the government itself, all aiming to eradicate HIV from India. With all this efforts the prevalence has reduced drastically as all these bodies have joined hands with the project. Its replication is also seen in these new organisations under United Nations which have come in to rescue the republic of India from this plague (UNAIDS, 2002).

Preliminary results

IBBA data has shown the following results which are as a result of Avahan Initiative and it proved that are moving in the right direction:

Large programmatic footprint recorded at the end of 2005

By this year, Avahan was now working with over 134 NGOs in over 530 towns in 83 most affected districts in the six states. In the same year it was being in a position to provide services for over 270,000 individuals who were at a higher risk of contracting the pandemic. Analytical data showed that over 65% of the infected were in a position to access a service centre and over 47% of those with other STI were freely receiving treatment (UNAIDS, 2002).

Increased intensity and depth of service delivery

IBBA data in the beginning of 2006 indicated that Avahan was increasing its reach at a very high rate. Its rate of expanding was not comparable to that of State AIDS Control or that of other donors (Bill and Melinda Gates foundation, 2011).

Increased rate of condom use

Commercial sex workers have now adopted the use of condoms in their sexual acts. This is one of the major sectors that have helped in the fight against HIV prevalence. This has been backed by the data corrected by different behavioural surveillance surveys programs, which mostly targeted female sex workers together with their clients between 2001 and 2006 (Family Health International, 2007).

Decrease in other STI among Female Sex workers

These figures have dropped drastically comparing with the case between 2000 and 2003 and those in between 2009 and 2011. Creation of awareness and other factors such as use of condoms are the key factors that have reduced these figures (Bill and Melinda Gates foundation, 2011).

The above reports are also practical evidence that the Avahan project is replicable.

Conclusion

Avahan project has played a big role in building a high-quality scaled program aiming at HIV prevention. Data has proved that there is a high use of condoms among sex transactions as well as reduction in other curable STIs among high-risk groups. In the next few years, the foundation aims to have enough data to evaluate its impact in the fight against HIV transmission. Overall India’s HIV landscape has changed and bit it is reducing day in day out as many more organisation are impacting on the fight against HIV transmission. The key challenge now in the future is addressing barriers, developing more advanced referral systems, increasing the quality of clinical services and ultimately transferring custodianship.

References

Bill and Melinda Gates foundation, 2011. Programs & Partnerships Retrieved on 21^st October 2011. Available at: http://www.gatesfoundation.org/avahan/Pages/overview.aspx

Ghys PD, et al. (2002). Increase in condom use and decline in HIV and sexually transmitted diseases among female sex workers in Abidjan, Cote d’Ivoire, 1991-1998. AIDS; 16:251-258.

Indian National AIDS Control Organization (NACO), (2003). Sentinel Surveillance data. New Delhi: NACO.

Hickey and Mohan (eds.), (2004). Participation: From Tyranny to Transformation. London: Zed Books.

Unaids, (2002). Report On The Global Hiv/Aids Epidemic. Unaids: Geneva.

Moses S, et al, (2006). AIDS in South Asia: Understanding and Responding to a Heterogeneous Epidemic. Washington, DC: World Bank.

Family Health International, (2007). Clinic Operational Guidelines and Standards: comprehensive STI services for sex workers in Avahan-supported clinics in India. New Delhi: Family Health International.