HIV AIDS in Nepal from UNDP's eyes

Regarding HIV/AIDS in Nepal, the UNDPsays:


Nepal has developed a "National Strategy on HIV/AIDS, 2002 - 2006", a costed 5-year Operational Plan with annual National Programme on HIV/AIDS (2004-2005). The National Programme is the overarching framework to guide, monitor and coordinate an expanded response to the epidemic in Nepal. Included in the National Programme, are the activities supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), and DFID (in a "programme" approach). It has also received parallel funding from AusAID and USAID (through their respective partners), and the UN system.

His Majesty's Government of Nepal (HMG/N), Ministry of Health (MoH), has requested the United Nations System in Nepal (the UN system) to support the implementation of the National Programme in assisting with the management of GFATM funded activities of the programme.

The project is directly executed by UNDP, as the administrative and management agent on behalf of the UN System in Nepal. HMG/ MoH/ National Center for AIDS and STD Control (NCASC) and one representative of the MoH in the expanded UN Theme Group on HIV/AIDS in Nepal, as the guiding and coordinating body for the UN System for the implementation of activities. In this regard, a Third-Party Cost-Sharing Agreement between His Majesty's Government of Nepal, Ministry of Health and the United Nations Development Programme (on behalf of the UN System Nepal), a project document was signed on 27 Feb 2005.

The HMG/N National Center for AIDS and STD Control (NCASC), as the principle-monitoring agent, will monitor the implementation through the agreed indicators with added responsibility in epidemiological surveillance, care, and support.

As Management Support Agency (MSA), the UN system will assist HMG/N, MoH, in managing specific activities funded by the GFATM which form part of the National Strategy on HIV/AIDS, for the period February 2005 to March 2006.

The total budget for the project amounts to US$ 3,181,380 for the period of Feb 2005 to March 2006.

The project is inspired by the principles of the Greater Involvement of People Living with HIV/AIDS (PLWHA).

HIV/AIDS in Five Development Regions
Facts
Focus Area HIV/AIDS
No of Program(s) 1
No of Districts covered 21


Programme
Regions Districts MSNP
Far Western Development Region Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Darchula
Doti
Kailali
Kanchanpur

Mid Western Development Region Banke
Bardiya
Dailekh
Dang
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Surkhet

Western Development Region Arghakhanchi
Baglung
Gorkha
Gulmi
Kapilbastu
Kaski
Lamjung
Manang
Mustang
Myagdi
Nawalparasi
Palpa
Parbat
Rupandehi
Syangja
Tanahu

Central Development Region Bara
Bhaktapur
Chitwan
Dhading
Dhanusha
Dolkha
Kabhrepalanchowk
Kathmandu
Lalitpur
Mahottari
Makwanpur
Nuwakot
Parsa
Ramechhap
Rasuwa
Rautahat
Sarlahi
Sindhuli
Sindhupalchok

Eastern Development Region Bhojpur
Dhankuta
Ilam
Jhapa
Khotang
Morang
Okhaldhunga
Panchthar
Sankhuwasava
Saptari
Siraha
Solokhumbu
Sunsari
Taplejung
Terathum
Udayapur

Management Support to the National Programme on HIV/AIDS - MSNP

Background

Nepal is facing rapid increase in HIV/AIDS prevalence among high risk groups. The first case of AIDS in Nepal was reported in 1988. By April 2006, more than 1025 cases of full-blown AIDS and over 6443 cases of HIV infection were reported officially. However, due to the limitations of the surveillance system, the actual number of infected people in Nepal is expected to be much higher. According to the Global AIDS Epidemic report 2006, it is estimated around 75000 people living with HIV/AIDS in Nepal.

The government of Nepal requested the UN system to serve as a Management Support Agency (MSA) for executing the Global Fund to Fight against AIDS, Tuberculosis and Malaria (GFATM) grant for HIV/AIDS for which the government is the Principal Recipient. Within the UN system, the responsibility of implementing the grant was given to the UNDP. A Programme Management Unit (PMU) was established at UNDP to manage the grant. Australian Aid for International Development (AusAID) also used the same modality for implementing the harm reduction activities which were being implemented by UNDP since 2004. The Department For International Development (DFID) also gave UNDP the responsibility of managing its funds for responding to the national HIV/AIDS action plan. DFID agreement with UNDP spans from 2005 – 2008. However, DFID has opted to have UNDP directly implement its 2006 - 2008 programmes outside of the UN MSA at UNDP arrangement.

Within the UN system, an MSA coordinating body was been formed to coordinate and monitor the activities conducted by UNDP on behalf of the UN System. Its membership includes UNICEF, UNDP, UNAIDS, UNFPA, NCASC and the Programme Manager of the HIV/AIDS PMU. Moreover, the UN HIV/AIDS theme group and the UN Technical Working Group, chaired by UNICEF and UNAIDS respectively, provide overall policy guidance and technical support to the MSA.

The UNDP HIV/AIDS Programme Management Unit is implementing the following activities from the National HIV/AIDS Plan 2005 -2006 and is directly contributing to the achievement of the national goals. In total 119 projects are implemented in 27 districts through 77 Non Governmental Organisations.

Mobile Population and Families Awareness Raising
Comprehensive Package for Mobile Population
Comprehensive Package for MSW
Comprehensive Package for IDUs
Drug Treatment
Comprehensive Package for MSM
Comprehensive Package for PLWHA
Safe Blood Supply
Adult and Paediatric Care and Support
Behavioural and Contextual Research
Awareness raising for Uniformed Forces
Behaviour Change Intervention among Uniformed Forces
Awareness Raising for Young People
Life Skill Intervention for Young People
Youth Friendly Information Services

Description of Key Activities:

Harm reduction activities for Injecting Drug Users

HIV/AIDS Harm Reduction Program among Injecting Drug Users in Nepal (IDUs) succeeds and builds on the lessons learnt from the multi-donor project “Nepal Initiative”. There are eight harm reduction partners in different location in Nepal providing essential advice and services for IDUs. This project aims to a) maintain and expand harm reduction activities, b) establish and expand oral substitution treatment, and c) design and implement social support services to support harm reduction activities linked to rehabilitation and Antiretroviral Therapy (ARVT).

Prevention and Care & Support activities among labour migrants and young people

The present political situation in Nepal has encouraged the outflow of migrants, many of whom are youth, to migrate towards major Indian cities. They remain out of country for a long period of time only visiting during major festivals. The HIV/AIDS prevention and care activity has targeted migrants and youth due to their increased vulnerability in engaging in high risk activities which are peer pressure, solitude and other underlying factors. The overall goal of HIV/AIDS programme is “To prevent HIV infection in labour migrants and young people in Nepal and provide care and support to the affected people".

The programme is implemented in six districts with high migration pattern, especially to India. The strategies to prevent HIV/AIDS/STI transmission executed by the programme are Advocacy; BCC; Peer Education; Establishment of Information Counselling Centres; Establishment of Youth Friendly Service Centre and Establishment of STI/VCT centres.

Comprehensive Package for IDUs

Injecting Drug Users (IDUs) constitute the population sub-group in which HIV threatens to rise most rapidly. Behavioural research among IDU in Nepal clearly indicates that needle sharing, the major risk factor for HIV, is common. Studies have shown that HIV prevalence among IDUs is high. Rapid assessment in 1999 showed HIV prevalence among IDUs nationwide of 40% and 50% in Kathmandu. Furthermore in 2002 a survey revealed that the prevalence rate has risen to 68% among IDUs in Kathmandu.

With the objective of reducing the HIV/AIDS incidence among the IDUs, comprehensive service package including primary health care services; IEC/BCC; community sensitisation; availability of clean needle and syringes; peer education; condom distribution; establishment of sti/vct service or referral links and counselling and psychosocial support has been planned.

Drug Treatment

The drug treatment activities for IDUs include procurement of methadone; oral substitution programme; rehabilitation and reintegration programme; development of guidelines for harm reduction and linkage to ART programme.

Comprehensive Package for Mobile Population and families

The National HIV/AIDS Action plan has identified the need to target mobile population and their families due to their increased vulnerability towards HIV/AIDS infection. The comprehensive package for mobile population and families includes the following activities: Community orientation and sensitisation; district planning; establishment of district information centres integrated with VCT/STI services or referrals; BCC and community media; development and distribution of destination package; cultural dramas and events.

Comprehensive Package for PLWHA

The comprehensive package for people living with HIV/AIDS includes community sensitization; peer education and psychosocial support, crisis care, home based care and strengthening of PLWHA network.

Comprehensive Package for MSM and MSW

The comprehensive package for MSM and MSW includes behaviour change communication; community sensitisation; peer education; condom distribution and social marketing; and establishment of VCT and STI service or referral links.

Adult and Paediatric Care and Support

The services under Adult and Paediatric Care and Support are procurement of ARVs for adults and paediatrics; procurement and training for CD4 and viral load; support to the establishment of grass root networks for home based care; support to hospice for palliative care and support patient follow up and outreach for ART.

Safe Blood Supply:

The support to the scale-up of blood transfusion services in Nepal is focussed on building capacity of blood banks in order to ensure the adequate , safe and timely supply of blood and blood products to meet the transfusion requirement of the people of Nepal in an equitable and affordable manner. The support incorporates the strengthening of institutional capacity of blood banks to collect and distribute safe blood and blood products. The support is also focused on standardizing the methodologies for grouping and HIV, HBsAG, HCV, Syphilis screening by development of Standard Operating Procedure (SOP) manual and capacity building thereof.

Donor Partner District
The Global Fund to Fight AIDS, Tuberculosis and Malaria Britain Nepal Medical Trust
Save the Children U.S.
Youth Power Nepal
Women Acting Together for Change
Himalayan Association Against STI-AIDS
Community Awareness Against HIV/AIDS and Drug Addiction
Association of Medical Doctors of Asia– Nepal
Innovative Forum for Community Development
Nepal Fertility Care Center
Federation of Nepalese Chamber of Commerce and Industries
Sakriya Sewa Samaj
Nepal Red Cross Society
Care Nepal
B.P. Memorial Health Foundation
Himalayan Social Welfare Organization
Institute of Cultural Affairs
Pro-Public
MRMG
GWP
ABC
CWC
Accham, Doti, Banke, Rupandehi, Chitwan, Jhapa, Dang and Kathmandu
AusAID Knight Chess Club
Help Group for Creative Development
Kirat Yakthum Chumlung Punar Jiwan Kendra
Bidhyarthi Jagaran Manch
Naulo Ghumti
Life giving and Life saving Society
Siddhi Memorial Foundation
Association of Helping the Helpless
Youth Power Nepal
Jhapa Sunsari, Morang, Kaski, Bara,Lalitpur,Kathmandu,Parsa, Kailali, Kanchanpur, Bhaktapur
DFID Addiction Recovery Centre
Association for Rural Social Welfare
Bidyarthi Jagaran Manch (BIJAM)
Blue Diamond
Community Support Group
Community Welfare Centre
General Welfare Pratisthan
Geruwa Rural Awareness Association
Help- Nepal Network
Happy Nepal Wisdom Foundation
Himalayan Social Welfare Organisation
Knight Chess Club
Kirat Yakthung Chumlung Punarjivan Kendra
Lifesaving and Lifegiving Society
Life line Help Group
Lumbini Drug Treatment and Rehab Center
Mountain Resource Management Group
Multipurpose Development Society
Nagarjun Development Community
Namuna Integrated Development Council
National Association of People Living with HIV/AIDS- Nepal
Nava Kiran Rehabilitation Centre
Nava Kiran Plus - Biratnagar
Nava Kiran Plus - Surkhet
Nava Kiran Plus - Chitwan
Nava Kiran Plus - Rupandehi
Nava Kiran Plus - Makwanpur
Naulo Ghumti-Kaski
Naya Goreto
Nepal Aradhana Samaj (Karuna Bhawan)
Nepal Plus
New Hope Foundation
Nepal Red Cross Society including Blood Transfusion Services
Oppressed Class and Women Awareness Center
PRERANA
Punarjiwan Sarokar Kendra
Recovering Nepal
Richmond Fellowship Male
Richmond Fellowship Female
Samjhauta Nepal
Sneha Samaj
Society Support Group
Sparsha Nepal
St. Xavier's Social Services
Support and Care Rehab centre
Women Acting Together for Change
Youth Power Nepal
Youth Vision
Safe Concern
Sustainable Development Facility
STEP Nepal
Jhapa, Morang, Sunsari, Dhanusha, Bara, Parsa, Makwanpur, Chitwan, Syangja, Kaski, Kathmandu, Lalitpur, Bhaktapur, Rupandehi, Bardiya, Surkhet, Kailali, Kanchanpur, Accham, Sarlahi, Mahottari, Dadeldhura, Kavre





› MSNP Programme Districts


Contact

UNDP Focal Point
Ms. Sara Nyanti
HIV/AIDS Unit
UN House, Pulchowk, P.O.Box 107 Kathmandu, Nepal
Tel: 977-1- 552 3200
Fax: 977-1-552 3991
Email: sara.nyanti@undp.org