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Tamil Nadu

Tamil Nadu - Chennai

City at forefront of awareness campaigns city pulse

Ramya Kannan

Tamil Nadu, led by Chennai, has done a lot for the campaign against HIV in the country

CHENNAI: In many ways, Chennai is where it all began. Be it the detection of the first cases of HIV in the country, establishment of the first State AIDS Control Society or setting up of networks of positive people, Chennai has always led from the front, the battle on HIV/AIDS. As the capital of Tamil Nadu, Chennai has invariably been at the forefront of some of the more progressive interventions and awareness campaigns the country has put forth.

The HIV epidemic is undoubtedly one of the biggest public health crises the country has seen. And in terms of record, it started many years ago in Chennai, when Suniti Solomon and her team found the first few cases of HIV in the country.

Possibly because of this, and the fact that Tamil Nadu has one of the better health systems interventions in the country, action began from the South. “In many respects, Tamil Nadu, led by Chennai, has done a lot for the campaign against HIV in the country,” says Suniti Solomon, director, YRG Care.

The mechanism was in place already to implement these interventions, but she adds that the activism that is characteristic to Chennai also pitched in to save the day. “Right from the beginning, there were a lot of NGOs in the field, mostly working in their own specific zones avoiding overlap. The co-ordination between these organisations and the government was excellent and barring a few black sheep, the organisations worked well to target different key concerns of the epidemic,” she explains.

Health secretary V. K. Subburaj says there are a number of organisations doing quality work in the state and city. With the HIV prevalence in the State stabilising at 0.25 per cent last year by stemming the increasing tide through interventions that combined prevention information with care for the positive, Tamil Nadu is obviously a success story so far.

S. Vijayakumar, project director, Tamil Nadu SACS (TNSACS), says, “There are three reasons why things have worked here. Firstly, without political will from the government in Chennai, we could have gone nowhere. Two other reasons are the comprehensiveness of the intervention programmes we have launched and their cost-effectiveness.” No wonder then that some of the projects launched in the State have now been picked up for replication in other States and the rest of the country.

While the sentinel surveillance reports are awaited, it is estimated that there are 8000 - 10,000 people with HIV in Chennai. With a population of 60 lakh, the prevalence rate is much lesser than the State average, according to P.Kuganantham, health officer, Chennai Corporation. The Corporation also houses a Chennai unit of the AIDS Prevention and Control Society. He points out that one of the most crucial State-run interventions — the Prevention of Parent to Child Transmission Programmes — was also launched as a pilot in the Institute of Obstetrics and Gynaecology, Egmore. Based on the success of this model, which used counsellors to inform parents of the risk of infection, it was later replicated in all government sector healthcare units, right down to the block-level hospital.

Chennai is also home to the Tuberculosis Research Centre where an ongoing trial for an HIV vaccine is on and the city’s top medical research institutes have hosted several clinical trials in the sector. A special office has been set up in the city to validate various claims to cure being made across the State, Mr. Subburaj informed. “A lot of claims are being made and this unit has been set up to validate at least the various formulations being put forth in the Siddha stream,” he adds. Clinical trials for Siddha formulations are also in the pipeline.

In an effort to take messages of prevention to the youth, the State set up Red Ribbon Clubs in colleges. Very soon, this became a crucial vehicle of taking health prevention messages into the community and eventually had a role in bringing down the actual prevalence. A recent Behavioural Surveillance Study conducted by APAV-VHS indicated that risk perception had come down among students. This is considered as one of the challenges to be addressed in future.

Mainstreaming

Another key challenge is to mainstream the issues of those infected with HIV, says Rama Pandian, founder, Tamil Nadu Network of Positive Persons. The Indian Network of Positive Persons, the first coming together of people infected by HIV, was also started in Chennai and activism has also been spearheaded from this city. “I have been involved in HIV/AIDS work since 1992 and clearly, while things have improved comparatively, stigma and discrimination continues to be high,” he says. While many positive people have been accessing the ARVs and other services resulting in a better quality of life and longevity, there is a need to bring HIV into the mainstream. The government should ensure that those marginalised by HIV have access to all the welfare schemes available across departments. “Acceptance for the community has to come from all sectors, not just STD clinics and TANSACS. Also, the State and Centre will have to increase their funding for various programmes,” he added.

MR. Subburaj says, “We know that there are challenges ahead of us. But we realise that if we address them, reducing sexually transmitted infections, increasing risk perception among youth, and reducing discrimination, it is possible to bring the State to a zero-transmission rate. This means no new infections. We can reach that in the near future.”

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