Kangra Zila Parishad in its quarterly meeting urged the union health secretary and state health secretary to ensure continuity of care support and treatment services to People Living with HIV/AIDS (PLHA) at Tanda (Kangra). Kangra district has highest burden of HIV detected in the hill state of Himachal Pradesh. “Being a welfare state, it is the mandate of the government to provide services for the vulnerable”, state Kishan Kumar, Secretary of the District Level Network.
The Zila Parishad, in its resolution has also called upon the deputy commissioner to provide interim relief form alternative sources to run the services till the decision was taken by central authorities, so that the services are not disrupted.
In the transition from NACP III to NACP IV, two of the three community care centers [CCC] ( Hamirpur and Shimla) were converted to Care Support Centers, while Tanda the highest burden zone was left without any services. Hundreds of people living with HIV/AIDS are bound to suffer with the community care center for the HIV/AIDS patients at Tanda, facing a closure on March 31.
The CCC had been providing a valuable service to the PLHA. CCCs provided essential service of short-stay homes for PLHA. The center had a homely ambiance, with facilities including stay, food, medicines, socialising.
The CCC played a critical role in enabling PLHA to access ART as well as providing monitoring, follow-up, counseling support to those who are initiated on ART, positive prevention, drug adherence, nutrition counseling, ensuring services with a smile and human touch.
A 24 hour helpline for positives, facilitating Prevention of Parent to Child Transmission by ensuring nevirapine for positive mother baby pairs, tracking Lost to Follow-up (LFU) clients of the ART center. In addition to initiatives for livelihood projects, with CCC being the hub of Self Help Groups of positives.
Expressing solidarity with the vulnerable population, Akshay Jasrotia, member of health committee Zila Parishad Kangra stated that there are 6582 People Living With HIV AIDS (PLHA) detected in the state presently, out of which 1852 are from Kangra district alone, 818 of them in the district are in Pre ART Care.
PLHA require care and treatment for opportunistic infections (OI) and some of these illnesses may require in-patient care. The District Level Network of people living with HIV Zindagi Zindabad questioned the logic of having a center for 455 people at Shimla, while non-inclusion of center at Tanda for higher population.
Unfit model – Special consideration for hill states needed.
The new model “Care Support Center” being run through “AIDS Alliance” at other places does not have medical care component and stay facility for PLHA and offers only skeletal services.
This model is not practical in hill states as travel time is high for short distance and public transport buses are infrequent, esp. in late evening when the patient will get free after getting his investigations and tests done at hospital with the ART center. Often the patient has to stay one day for collecting the report and consulting his physician, but the doctor may not admit him in the hospital as he is ambulatory. Hence there is a unmet need for short-stay homes for PLHA.
This gap needs to be addressed urgently, to improve quality of life and out of pocket expenses on accessing Anti Retroviral Treatment (ART) drugs. The Zila Parishad has endorsed the demand of the positive citizens, as and recommended to the government that stay facility be retained for hill states as special consideration of the geography and difficult terrain.