PARLIAMENT OF 42

DEPARTMENT - RELATED PARLIAMENTARY STANDING COMMITTEE ON HEALTH AND FAMILY WELFARE

FORTY-SECOND REPORT ON DEMANDS FOR GRANTS 2010-11 OF THE DEPARTMENT OF AIDS CONTROL (MINISTRY OF HEALTH AND FAMILY WELFARE)

(PRESENTED TO THE RAJYA SABHA ON 28TH APRIL, 2010) (LAID ON THE TABLE OF THE ON 28TH APRIL, 2010)

RAJYA SABHA SECRETARIAT NEW APRIL, 2010/VAISHAKHA, 1932 (SAKA)

Website:http://rajyasabha.nic.in E-mail:[email protected]

PARLIAMENT OF INDIA RAJYA SABHA

DEPARTMENT - RELATED PARLIAMENTARY STANDING COMMITTEE ON HEALTH AND FAMILY WELFARE

FORTY-SECOND REPORT ON DEMANDS FOR GRANTS 2010-11 OF THE DEPARTMENT OF AIDS CONTROL (MINISTRY OF HEALTH AND FAMILY WELFARE)

(PRESENTED TO THE RAJYA SABHA ON 28TH APRIL, 2010) (LAID ON THE TABLE OF THE LOK SABHA ON 28TH APRIL, 2010)

RAJYA SABHA SECRETARIAT APRIL, 2010/VAISHAKHA, 1932 (SAKA) CONTENTS

PAGES

1. COMPOSITION OF THE COMMITTEE...... (i)-(ii)

2. PREFACE ...... (iii)

3. REPORT ...... 1-13

4. OBSERVATIONS/RECOMMENDATIONS ---- AT A GLANCE ...... 14-19

5. MINUTES ...... 21-26

COMPOSITION OF THE COMMITTEE (2009-2010)

1. Shri Amar Singh ----- Chairman

RAJYA SABHA 2. Shrimati Viplove Thakur 3. Dr. 4. Shri Janardan Dwivedi 5. Shri Balbir Punj 6. Dr. Prabhakar Kore 7. Shrimati Brinda Karat 8. Shrimati Vasanthi Stanley 9. Dr. M.A.M. Ramaswamy 10. Dr. Anbumani Ramadoss

LOK SABHA 11. Shri J. M. Aaron Rashid 12. Shri Ashok Argal 13. Shrimati Sarika Devendra Singh Baghel 14. Shri Vijay Bahuguna 15. Dr. Chinta Mohan 16. Shrimati Tabassum Hasan 17. Dr. Sanjay Jaiswal 18. Shri S. R. Jeyadurai 19 Dr. (Shrimati) Kruparani Killi 20. Shri N. Kristappa 21. Dr. Tarun Mandal 22. Shri Datta Meghe 23. Dr. Jyoti Mirdha 24. Shrimati Jayshreeben Patel 25. Shri R.K. Singh Patel 26. Shri M. K. Raghavan 27. Dr. Anup Kumar Saha 28. Shrimati Meena Singh 29. Dr. Arvind Kumar Sharma 30. Shri Pradeep Kumar Singh 31. Shri Ratan Singh

SECRETARIAT Shrimati Vandana Garg, Additional Secretary Shri R. B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Assistant Director Shti Satis Mesra, Committee Officer

PREFACE

I, the Chairman of the Department-related Parliamentary Standing Committee on Health and Family Welfare, having been authorized by the Committee to present the Report on its behalf, do hereby present this Forty-second Report of the Committee on the Demand for Grants of the Department of AIDS Control, Ministry of Health and Family Welfare for the year 2010-11.

2. The Committee considered the various documents and relevant papers received from the Department of AIDS Control, Ministry of Health and Family Welfare and also heard the Secretary and other officials of the Department on the said Demands for Grants (2010-11) in its meeting held on the 6th April, 2010.

3. The Committee considered the Draft Report and adopted the same in its meeting held on the 26th April, 2010.

AMAR SINGH NEW DELHI; Chairman, th 26 April, 2010 Department-related Parliamentary Vaishakha 7, 1932 (saka) Standing Committee on Health and Family Welfare

REPORT

I. INTRODUCTION

1.1 India, the second largest country in the world, also has the third largest number of people living with HIV / AIDS. As per the provisional HIV estimate of 2008-09, there are an estimated 22.71akh people living with HIV / AIDS in the country. The epidemic is concentrated among high risk group populations and is heterogenous in its spread.

1.2 The National AIDS Control Programme launched in 1992, is being implemented as a comprehensive programme for prevention and control of HIV / AIDS in India. Improved understanding of the complex HIV epidemic in India has enabled substantial changes to be made in the policy frameworks and approaches of NACP. The focus has shifted from raising awareness to behaviour change, from a national response to a more decentralized response and to increasing involvement of NGOs and network of people living with HIV / AIDS.

1.3 The National AIDS Control Programme Phase-III has been introduced with the aim to halt and reverse the AIDS epidemic in India over the five year period, i.e., 2007-2012. The programme hopes to achieve this through a four pronged strategy:

Prevent infection through saturation of coverage of high-risk groups with Targeted Interventions (TI) and scaled up interventions for the general population.

Provide greater care, support and treatment to larger number of People Living with HIV / AIDS (PLHA).

Strengthen the infrastructure systems and human resources in prevention, care, support and treatment at the district, State and National levels.

Strengthen the nationwide Strategic Information Management System to help track the epidemic and identify pockets of infection.

II. BUDGETARY ALLOCATION

2.1 The Committee takes note of the trend of utilization of funds by the Department during the first three years of the Eleventh Plan period:-

(Rs in crore) Year Allocation RE Exp.

at BE stage

2007 -08 815.00 953.89 917.59

2008-09 1100.00 1123.36 1032.09

2009-10 1100.00 980.15 961.65

2010-11 1435.00

There has been optimum utilization of allocated funds under NACP III so far. The only exception is that during 2008-09 inspite of marginal increase at the RE stage, pace of utilization at the end of the year was not very satisfactory with Rs. 91.00 crore remaining unspent at the end of the year.

2.2 Regulation of release of funds to the State AIDS Control Societies due to availability of considerable balances with them has been cited as the main reason for this saving. On a specific query in this regard, the Committee was informed that opening balance amounting to Rs. 219.55 crore was available with SACS as on 1st April, 2008. Position was similar with opening balance of Rs. 238.68 crore being available at the beginning of 2009-10 also. A comparative analysis of State-wise figures during 2008-09 and 2009-10 indicates that main defaulter State AIDS Control Societies remained unchanged. Following details are self-explanatory:-

(Rs. in crore) SACS 2008-09 2009-10

Opening Balance Opening Balance

Andhra Pradesh SACS 25.96 37.37

Karnataka SACS 14.74 21.70

Maharashtra SACS 22.11 34.41

Nagaland SACS 10.05 12.97

Tamil Nadu SACS 17.18 13.71

Uttar Pradesh SACS 21.98 9.35

Delhi SACS 10.78 12.38

2.3 The Committee was informed that due to action taken by NACO, quantum of unspent balance has gradually declined over the year and the closing balance with the SACS at the end of 2009-10 was only Rs. 128.84 crore.

2.4 The Committee appreciates that with focused intervention of NACO, there is a considerable decline in unspent balances available with the Societies. The Committee would, however, like to point out that availability of unspent balance with some SACS, like Karnataka SACS (Rs. 11.34 crore), Tamil Nadu (Rs. 8.40 crore) and West Bengal (Rs. 8.99 crore) is still quite high. The Committee, therefore, recommends to the Department to introduce stricter monitoring mechanism and financial discipline so that funds do not get accumulated and remain unutilized.

2.5 The Committee was informed that there were constraints being faced by these Societies. These included structural issues like no supportive structure below State level which has been resolved by forming District AIDS Prevention & Control Units, especially in high priority districts to coordinate the activities at district level. The second constraint relates to personnel viz. large vacancies at SACS, non- availability of qualified staff and weak capacity of State personnel. These have been resolved by authorizing the States for contractual appointments, relaxation in either qualification or experience on case to case basis and providing more attractive remuneration package. The third problem area was that of training and capacity building issues for which the Department has made training and capacity building as one of the components of the programme with development of training modules and establishment of State Training and Resource Centres. Last problem area was weak monitoring of SACS, poor financial management and reporting, and large outstanding balances on account of advances to peripheral units. The Department has stated that regular monitoring of activities by NACO is being done to identify the bottlenecks and help Societies in resolving them. Further, Computerized Project Management System (CPFMS) is used in all SACS to monitor financial progress. To address outstan-ding balance problems, NACO is now implementing e-payments of releases to SACS and insisting SACS for e-payment to peripheral units. 2.6 The Committee would, however, like to point out that these efforts need to be sustained till the elimination of all the problem areas being faced QY different States. The Committee is constrained to observe that there was downward revision of funds at the RE stage during 2009-10. The Committee does not find any merit in the justification putforth by the Department that across the board cut resulted in the downward revision of funds. In the Committee’s opinion, opening balance of Rs. 238.68 crore at the beginning of 2009-10 seems to be the main reason for reduction of allocated funds during the year. The Committee would like to point out that various components under NACP deserve to be pursued vigorously and any cut in funds for the same would severely hamper the ongoing fight against the deadly disease.

2.7 The allocation projected by the Department for 2010-11 was Rs. 1494.43 crore which was restricted to Rs. 1435.00 crore by the Planning Commission. Significant component of capital expenditure for establishing Blood Banks in 4 Metro cities, viz., , Delhi, and Chennai would be adversely affected as the allocated domestic budget support would not be available and the Department would be seeking enhanced allocation therefor.

III. ROLE OF NGOs

3.1 The Committee understands that NACO identifies NGOs through an elaborate mechanism for implementation of Targeted Interventions (TI) by SACS. In response to a query regarding blacklisted NGOs, the Committee has been informed that during 2007, 176 NGOs implementing TI were discontinued to restructure the TI programme in the country. In 2008, 21 NGOs implementing TI were discontinued based on their poor performance. It has been stated that the performance of TI NGOs (both physical and financial) is evaluated by external experts to comply with World Bank norms. The performance evaluation is done against a set of performance indicators already agreed upon during the contract. As regards details of the unspent balances available with these blacklisted NGOs and the action taken to recover the same, the Committee has been apprised that as per information available from 13 States, an amount of Rs 16.65 lakhs has been recovered out of Rs 37.91 lakhs recoverable from 47 NGOs terminated during 2007 and 2008. Action has been initiated with respect to the recovery of Rs 21.26 1akhs by carrying out internal audit and necessary action as mentioned in the contract norms.

3.2 The Committee is dismayed to note that even after about two years, the Department has not been able to recover the unspent funds available with the discontinued NGOs. There appears to some slackness on the part of the Department and the other implementing agencies. Further, the fact that the Department has information only from 13 States, is an indicator of poor monitoring and control. The Committee would, accordingly, like to have a complete updated status till 2009-10 on this inter-alia containing the issues like contract norms fixed for NGOs, their selection criteria, number of blacklisted/discontinued NGOs - State-wise alongwith officials in the Government set-up held responsible, if any, for poor monitoring/selection, unspent funds available with such NGOs, amount recovered and the reasons for delay in recovering the same. The Committee would also recommend imposing severe penalties on NGOs which indulge in fraud or financial embezzlement.

3.3 The Committee apprehends that the discontinued/blacklisted NGOs may also resurface again by changing their name or place of work. The Committee would like to be apprised about the specific steps taken by the Department to thwart any such attempts by such NGOs and share with it such instances, if any, when it has been successful in preventing re-entry of such NGOs in the NACO network.

3.4 The Committee observes that achievement level of various components under NACP during the first three years of the Eleventh Plan period has been more or less satisfactory. Significant achievement has been reported under treatment of new STI cases and persons living with HIV/ AIDS, setting up of ART Centres, Community Care Centres and Integrated Counselling and Testing Centres. However, the same cannot be said about other components. Against 220 lakh persons to be counseled and tested at the ICTC every year, target has remained between 46.00 lakh to 85.00 lakh and that too, has remained unaccomplished.

3.5 The Committee is constrained to observe that the achievement level under many of the physical targets set during 2009-10 has been far from satisfactory. There are instances of severe under- achievements under the components like --- Setting new core group targeted interventions; setting up new bridge population targeted interventions; setting up new Blood Component Separation Units; setting up new District Level Blood Banks etc. The Committee fails to understand that under such circumstances how the Department has utilized more than 98 % of the funds during 2009-10 without achieving the satisfactory level of achievement under many of the physical targets. The Department needs to understand that it is good to achieve financial targets but what is more important is that achievement of the financial targets should be commensurate with the achievement of the set physical targets. The same is apparently missing here. Under such circumstances, the Committee has serious doubts over the planning and the subsequent execution strategies of most of the components of the Programme. The Committee can only infer that either the funds sought have been miscalculated or the Department has pumped in more money under certain components running successfully whereby it could show a higher percentage of utilization of allocated funds. The Department needs to clarify the same.

IV. SETTING UP OF NEW BLOOD COMPONENT SEPARATION UNITS (BCSUs) 4.1 The progress reported during the Eleventh Plan period so far under the target of setting up of new Blood Component Separation Units has been very discouraging. Out of 162 such units targeted to be set up, during the first three years of the Plan period only 47 units could be set up. As informed by the Department, the reasons for targeted units not being set up are on account of non-compliance by the States to the requirements as laid down under the provisions of Drugs and Cosmetics Act for setting up of Blood Component Separation Units (BCSUs). This includes infrastructural requirement of 7 rooms in an area of 150 sq.mts and availability of manpower trained in Blood Component Separation, to be undertaken by States. It was also clarified that under the Programme, 131 Blood Component Separation Units are fully functional and there are 33 more units to be set up in the last two years of the Eleventh Plan period.

4.2 The Committee is constrained to observe that the data made available to the Committee through the response to a query made twice reveals that the Department has fixed a target of 162 for setting up of new Blood Component Separation Units by the end of the Eleventh Plan. The Committee notes that no target was fixed for the first year, i.e., 2007-08, and for 2008-09 and 2009-10, 40 BCSUs each were kept as targets. However, a cumulative achievement of only 47 BCSUs could be made till February 2010. Out of the total target of 162 units for the Eleventh Plan period, a total of 115 more such units are required to be set up during the last two years of the Eleventh Plan period. The Committee would like the same to be clarified.

V. SETTING UP OF NEW DISTRICT LEVEL BLOOD BANKS

5.1 The Committee is given to understand that at present, 783 low volume blood banks are functioning in various districts of the country. During the planning of NACP Phase - III, an assessment was carried out about the requirement of blood banks in the country. Accordingly, a target of setting up of 39 Blood Banks in newly created districts was kept in NACP - III. The States which are having maximum shortfall of low volume blood banks in districts are and Jharkhand.

5.2 The Committee notes that against the target of setting up of 39 Blood Banks during the Eleventh Plan, a target of only 15 Blood Banks was fixed during the first three years of the Plan. Further, against an already low target of 15 Blood Banks, only 11 Banks could be set upto February, 2010. When enquired about the reasons for the same, the Department has stated that against the target of setting up of Blood Banks in the 39 newly created districts with support under NACP III, 10 districts have obtained the license to operate as a Blood Bank in district level hospitals. Out of the remaining 29 districts, in 6 districts, necessary requirements as per provisions of the Drugs and Cosmetics Act have been provided and these blood banks are waiting for joint inspection from State Drug Control Authorities for issuance of licenses. The constraints in setting up the blood banks in these districts are non availability of adequate infrastructure, manpower and delay in issuance of license. 23 districts are not having a district hospital of their own. The matter is being followed up with the State Governments from time to time. In the remaining districts, the blood banks will be set up only after the conditions are fulfilled as per the provisions of the Drugs and Cosmetics Act.

5.3 The Committee is dismayed at the fact that the Department has not been able to take up the matter of setting up of the district level blood banks with a sense of urgency. The Department itself is aware that these 39 Blood Banks have been identified on the basis of an assessment of urgent requirement in underserved areas. Hence, a delay in setting up of the blood banks as envisaged, is against Department’s obligations to see that the facilities reach these underserved areas. Most of the reasons cited for the delay are non-availability of adequate infrastructure, manpower and delay in issuance of license. The Department needs to play a pro-active role by taking up the matter with the concerned State Governments as well as the agencies at an appropriate level to expedite the procedural formalities. The Department should also consider providing appropriate additional funds, if required, for infrastructure and manpower related matters so that there is no delay due to financial constraints. 5.4 The Committee also recommends to the Department to take special notice of the underserved districts of Uttar Pradesh and Jharkhand. The Committee also hopes that the Department would keep on assessing the requirements of Blood Banks based on actual needs in various States due to migration and other issues.

5.5 The Committee is given to understand that a provision of Rs. 25.00 crore has been made for 2010-11 for establishing Blood Banks in 4 Metro cities, i.e.Kolkata, Delhi, Mumbai and Chennai as Centres of Excellence. These banks will have state-of-the-art facilities with 100 per cent blood components preparation and a capacity to process more than 100,000 units of blood annually.

5.6 In reply to a query regarding the progress in this regard the Committee is informed that the respective State Governments have confirmed the availability of land for the proposed Blood Banks. NACO has selected Design DPR Consultants who have submitted their preliminary designs for Delhi, Chennai and Kolkata site of the Metro Blood Banks, which are in the process of approval. During the year 2010-11, the construction of these metro blood banks is proposed to be initiated for which a provision of Rs.25.00 crore has been requested for.

5.7 The Committee welcomes this new initiative of the Department for establishing four Metro Blood Banks as Centres of Excellence. However, the Committee is unhappy to note the slow progress of the Department in realizing this initiative which has been pending since 2008-09. These blood banks would not only act as model blood banks with latest equipments and technology but would also be of great help in meeting the ever rising demands of these metro cities. The Committee however notes from the records available with it that no deadlines have been set regarding making the same functional. Keeping in mind the delay already made in implementation of this initiative, the Committee recommends to the Department to have a targeted approach in making the four metro blood banks functional at the earliest. The Committee would also like to draw the attention of the Department to the undue delay in the operationalisation of model Blood Bank at Tirupati. Infrastructure for the Blood Bank has already been provided by the State Government. The Secretary assured the Committee that action for sending the equipment for the Blood Bank would be taken immediately.

VI. INTEGRATED COUNSELLING AND TESTING CENTRES (ICTC)

6.1 The Committee notes that the Eleventh Plan target under this component is 75 lakh mothers to be counseled and tested per year. However, the target has been kept very low during the Plan period so far, and even that remained unachieved as indicated below:-

2007-08 2008-09 2009-10

Target Achievement Target Achievement Target Achievement

52.7 35.1lakhs 56.2 46.31 lakhs 70.15 47.83 lakhs

lakhs lakhs lakhs

6.2 It was clarified that the annual targets are fixed in consultation with SACS depending on the achievement of the previous year, expansion plans for the current year and the overall capacity. The target of 75 lakh/year is for the end of NACP-3 i.e. March 2012. During 2009-10 itself a target of 70.15 lakh/year was fixed which is almost close to the NACP-3 (Eleventh Plan) target of 75 lakh/year. Hence targets are not kept lower than what was envisaged. It was further stated that the targets for counselling and testing of pregnant women have been substantially achieved. The achievement of results under this programme is linked with institutional delivery. Institutional delivery is low in some States, particularly in North India; which was the reason for not fully achieving the targets.

6.3 The Committee is not convinced with the evasive reply of the Department. In the opinion of the Committee, while fixing targets for some component, one has to realistically assess all the hurdles/problem areas vis-a-vis the abilities of the system to deliver and achieve the same. Before fixing a target the Department should have taken into account all the relevant factors. Low level of institutional delivery being cited as the negative factor amounts to criticizing its own planning.

6.4 This needs focused attention of the Department, since the Department has itself informed the occurrence of rising trends of HIV prevalence among pregnant women in the low prevalence/ vulnerable States of North India. The Committee is of the opinion that the Department can hope for achieving the set targets by proper planning and execution. It needs to strengthen its network of ICTCs and focus on strong Information, Education and Communication activities in such States to motivate institutional deliveries.

VII. PERSONS TO BE COUNSELED AND TESTED AT ICTCs (Target of 220 lakh per year)

7.1 The Committee is given to understand that the overall target of 220 lakh/ year people to be counseled and tested in ICTCs comprises of all clients who come to an ICTC including pregnant women. The overall target of 220 lakh/year people to be counseled and tested in ICTCs is for the end of NACP-III i.e. March 2012. Following is the achievement level under the component during the Eleventh Plan so far:-

2007-08 2008-09 2009-10

Target Achievement Target Achievement Target Achievement

99.5 78.4 lakhs 122.9 102.18lakhs 155.34 127.47 lakhs

lakhs lakhs lakhs (till end of Feb.)

7.2 The Committee is informed that the Department is on the right track of setting up the target of 220 lakh/year by the end of March 2012. However, it also admitted to slight underachievement of target which was on account of shortage of kits due to quality issues as well as shortage of laboratory technicians in States such as Orissa.

7.3 In response to a query regarding the shortage of kits, the Committee was informed that the quality issues as regards HIV test kits have been addressed and as of now they stand resolved. The shortage of lab technicians in States such as Orissa is on account of less number of medical colleges that offer the DMLT course, which is a minimum qualification required for employment as lab technician in an ICTC. It has been informed that as per the guidelines of the National Accreditation Board for Testing and Calibration Laboratories (NABL), the qualifications for employment as Laboratory Technician in an ICTC have been revised now and the same will ensure the availability of adequate staff in ICTCs in States such as Orissa.

7.4 The Committee is happy to note that the quality issues related to HIV test kits have been resolved. The Committee hopes that the Department would keep a close monitoring of the quality related aspects of the kits so that such problems do not recur. The Committee also appreciates that some concrete steps have been taken to solve the issue of shortage of lab technicians by way of revising the guidelines of NABL. The Committee hopes that with concerted efforts like these, the Department would see an increase in the achievement level.

VIII. ART CENTRES

8.1 Achievement level with regard to setting up of ART Centres during the Eleventh Plan period has been satisfactory. There are nearly 9 lakh patients registered for ART in the country. This number is gradually increasing as more and more HIV +ve persons become eligible for treatment. Currently 269 ART centres are fully functional and providing treatment to nearly 3,02,896 persons requiring ART without any waiting time. Usually 30 to 35% of HIV+ve persons require ART based on eligibility criteria.

8.2 The Committee in its previous reports has been actively taking up the issue of availability of the second line of treatment so that the sufferings of patients, who have been receiving anti-retroviral treatment (ART) under the National AIDS Control Programme and have become drug resistant, can be lessened to some degree. The Committee has been given to understand that patients who fail on first line ART are referred from 269 ART Centres to the linked 10 Centers of Excellence. Such patients are further investigated to assess requirement of second line ART. These Centres of Excellence are equipped for such investigations and starting second line ART. Currently 1051 patients are stated to be on second line ART. All patients who are seeking ART from government supported centres, persons below poverty line, widows and children are eligible to get second line ART free of cost. The number of Centres of Excellence will be increased in the coming years to commensurate with the need.

8.3 The Committee is satisfied that at present the number of patients undergoing second line of ART is within the manageable range. However, the Committee is of the considered opinion that the number of Centres of Excellence being limited to just 10 where the patients can have treat-ment facilities, the patients, especially the poor people residing far away from these Centres, will have to spend a lot of money for transportation for visiting these Centres regularly. The Committee thinks that with the facilities of ART Centres expanding, more number of patients requiring second line of treatment is going to increase considerably. Accordingly, the Committee recommends to the Department to have a realistic assessment of the requirement of new Centres of Excellence with a view to make the facilities for treatment available within reasonable distance of the patients.

IX. NEW INITIATIVES 9.1 The Committee is aware that the Department had taken up the following new initiatives during 2008-09:

Setting up of National Blood Transfusion Authority.

Setting up of a Plasma Fractionation Plant.

The draft Cabinet Note on setting up of National Blood Transfusion Authority was prepared and sent to various Departments for their comments. Based on the comments received, the draft has been revised and is being followed up. In respect of Plasma Fractionation Centre, it has been informed that as recommended by the Expert Working Group, it has peen decided to adopt “Cohn n Chromatography” technology for this project. An EOI for Project Management Consultant (PMC) will be issued by March 2010.

9.2 The Committee is pained at the slow progress in establishing the National Blood Transfusion Authority and setting up of a Plasma Fractionation Plant. Both these initiatives are very important. It is very disappointing that the same still remains on paper even after two years. The Committee would like to be informed about the reasons for the inordinate delay and the deadline by which the same would be set up. It recommends to the Department to make all conceivable efforts to achieve the aforesaid targets at the earliest.

X. ADOLESCENCE EDUCATION PROGRAMME (AEP)

10.1 The Committee has been given to understand that in 2005, NACO in collaboration with the Ministry of Human Resource Development started the implementation of the Adolescence Education Programme (AEP) targeting students in IX and XI standards. The Programme is a key intervention to build life skills of the adolescents to enable them to cope with negative peer pressure, develop positive behaviour and prevent HIV infections. In 2007, the Programme was suspended by eight States due to the concerns raised against the content of the material used under the Programme. The matter was also taken up by the Committee on Petitions, Rajya Sabha in 2007 which recommended revision in the material. Since then, the material has been reviewed by an expert committee constituted by NACO in consultation with M/HRD and NCERT. The revised material was disseminated to States. As a follow-up some States have completed the adaptation process of the material including Andhra Pradesh, Arunachal Pradesh, Assam, Delhi, Goa, Haryana, Tamil Nadu, , Orissa, Punjab, West Bengal and Jharkhand. The Committee is informed that Andhra Pradesh, Arunachal Pradesh, Goa, Tamil Nadu, Kerala, Orissa, Punjab, West Bengal and Jharkhand have started the implementation of the Adolescence Education Programme (AEP) as per the revised material which was adapted by these States. Assam is likely to start implementation as per the revised programme from the year 2010-11. However, Delhi and Haryana are yet to implement the Programme as per the revised material. Kerala has resumed the implementation of Adolescence Education Programme after having series of consultations to seek consensus on the revised toolkit, after incorporating the changes, adapted a new module and have organised training of resource persons in four districts. The States of Chhattisgarh, Karnataka, Madhya Pradesh, Maharashtra, , , and Uttar Pradesh were approached for implementing the revised AEP. The revised material was disseminated to these States in July 2008 with the direction to adapt the revised material and implement the AEP. However, the programme continues to be suspended in these States.

10.2 As per latest figures made available to the Committee, during 2009-10, about 47000 schools were covered across the country under the Adolescence Education Programme implemented by NACO in collaboration with the State Education department against the target of 43956 schools.

10.3 The Committee is happy to note that the Department in collaboration with the Ministry of Human Resource Development (MHRD) has been able to allay the apprehensions of many of the States w.r.t. implementation of the Programme. The Committee fully shares the concerns of the various State Governments regarding suitability of the contents of the Programme due to various demographic and cultural diversities that exist in the country. However, the Committee is of the opinion, that the Programme, which aims at generating awareness amongst adolescents under its preventive strategy, is the need of the hour against this deadly disease. With changes in the study material and new modules already introduced under the revised AEP which take care of the concerns of the States, the Committee hopes that the Department needs to make concerted efforts alongwith MHRD to bring the remaining States on board where the Programme is still under suspension. The Committee may be informed about the efforts made by the Department in this regard.

XI. NEW STRATEGIES

11.1 Setting up of District AIDS Prevention and Control Unit (DAPCU) ---- Of 156 districts where setting up of DAPCU has been sanctioned, DAPCU has been set up in 151 districts. Barring Bihar (2) and Haryana (1), all States have set up DAPCUs in Category ‘A’ districts as per the requirement. With regard to ‘B’ category districts, Assam (1) and Bihar (1) have yet to set up DAPCUs.

11.2 Scheme of link workers in rural areas of category A and B districts - The activity has to be implemented in all category A and B districts. A total of 187 category A and B districts are to be covered. During 2009-10, the scheme was initiated in 126 districts. For the FY 2010-11, it is proposed to expand the programme in another 61 districts.

11.3 Collaboration with NRHM :

In 2009-10, there were 5135 stand alone ICTCs model and 930 ICTCs in 24x7 PHCs under facility integrated model in collaboration with NRHM. It is proposed to set up ICTCs in all 24x7 facilities (PHCs& CHCs) in phases. For the year 2010-11 discussion are being held with States to finalize number of additional facilities to be strengthened for ICTCs. ICTCs also provide HIV-TB Collaborative services and cross referrals with the RNTCP programme. The monitoring process of cross referral is proposed to be strengthened to reduce missed opportunities.

Provide PPTCT training to doctors, nurses at ICTCs & close monitoring for assured access to services.

Currently 230 ART centers are functional with provision of human resources, equipment, training & logistics at identified facilities. Consultation with SACS are ongoing to decide the number of additional ART centers to be opened in year 2010-11.

Presently 300 Link ART centers are functional to facilitate delivery of ART drugs nearer to residence of stabilized PLHAs. Discussions with states are ongoing to decide the number of new link ART centers to be opened in year 2010-11.

For STI services at PHCs & CHCs, NACO is coordinating with NRHM and has proposed to procure colour-coded drug kits for the PHCs and CHCs under NRHM. Proposals are being developed for joint training plan and operational guidelines for doctors & lab. Technicians and common treatment protocols.

Assist in skill up-gradation & quality monitoring of blood storage centers in FRUs.

Proposal to include HIV related service in IPHS facility accreditation systems.

Upgrading ASHA training modules on HIV related contents & improving community awareness & referrals through ASHA’s.

Exploring setting up of Oral Substitution Therapy clinics in identified hospitals for which protocols have been developed by NACO. Addressing stigma & discrimination against PLHA at public health facilities through communication campaigns with a component on service providers & health facility.

Joint Condom promotion through Social Marketing Organizations in high fertility & high HIV prevalence districts.

11.4 Preferred private provider scheme for management of sexually transmitted infections among high risk groups - During 2009-10, 4533 preferred private providers were identified by targeted interventions projects in their project area so as to provide quality STI care near to the high risk population. All these preferred private providers have been trained in syndromic case management and drugs will be provided by TI projects. During 2010-11, the scheme will be continued with a strong element of supportive supervision and monitoring.

11.5 The Committee is happy to note the progress made with regard to the new initiatives started in 2009-10. The Committee is of the opinion that setting up of the District AIDS Prevention and Control Units would fill up the necessary gap required as a supportive structure below the state level to coordinate the activities at the district level. The Committee would recommend expanding the same to more districts in the near future so as to implement the Programme effectively.

11.6 The Committee notes that the Link Work Scheme is an intensive rural-based intervention reaching out to the marginalized groups which remain uncovered even after the expansion of urban based prevention programmes. However, the Committee notes that the same is being implemented only in 18 States as of now. The Committee recommends to the Department to assess the need to cover the remaining States and closely monitor the scheme as the success of this scheme is crucial for achieving the goal of halting and reversing the epidemic of AIDS.

11.7 The Committee welcomes Department’s collaboration of its various activities with the backbone of India’s healthcare delivery system in rural areas - the NRHM. The Committee hopes that the Department would keep in close touch with the Department of Health and Family Welfare and explore more avenues to use its infrastructure and manpower under NRHM to further its various activities.

11.8 The Committee hopes that the Department would expand the preferred private provider scheme for management of sexually transmitted infections among high risk groups from existing 11 States to all the States having High Risk Groups in 2010-11. However, the Committee recommends close and strict monitoring of the scheme as the numbers may be fudged by the provider to get the token amount of Rs. 50 which is being given as consultation.

XII. NATIONAL PEDIATRIC INITIATIVE

12.1 The Committee has been given to understand that at present there may be around 70,000 HIV+ children in the country. After launch of National Pediatric Initiative in November 2006, there has been rapid identification of HIV+ children and currently nearly 60 thousand children have been registered at ART centres in the country. The predominant mode of HIV transmission in children is stated to be from HIV+ pregnant women to new born children. To prevent this transmission, Prevention of Parent to Child Transmission (PPTCTC) programme is being implemented which envisages counseling and motivation of pregnant women attending ante-natal clinics to opt for HIV testing, identification of HIV+ pregnant women and providing them ART or prophylactic treatment based on immunological status. During the year 2008, 21349 HIV+ pregnant women were detected and 10613 (49%) mother-baby pairs were given prophylactic treatment. In the year 2009, 19357 HIV+ pregnant women were detected and 11489 (59%) mother- baby pairs were given prophylactic treatment. 12.2 In response to a query regarding the status of HIV positive children in the High Risk States of Andhra Pradesh and Tamil Nadu, the Committee is informed that till January 2010, 13793 HIV positive children have been registered and 3346 eligible HIV+ children are on pediatric ART in Andhra Pradesh whereas, 7847 HIV positive children have been registered and 2430 eligible HIV positive children are on pediatric ART in Tamil Nadu. The Committee is also given to understand that rising trends of HIV prevalence among pregnant women are noted in some of the low prevalence/vulnerable States of North India such as Gujarat, West Bengal, Orissa, Rajasthan, Uttar Pradesh and Bihar.

12.3 The Committee is very concerned at the increasing number of HIV + children and rising trend of HIV prevalence in pregnant women in low prevalence/ vulnerable States of North India. However, the Committee considers it to be due to Department’s proactive approach in identifying and tracking the HIV+ mothers or it may be an indication of rise of the disease in the low prevalence States. The Committee would recommend to the Department to keep a strict vigil on rising trends of HIV prevalence among pregnant women in low prevalence States and take immediate steps to contain the same. The Committee may be informed of the specific steps taken by the Department in this regard.

12.4 The Committee is pained to imagine the plight of the small children who would be requiring the ART treatment in the long run. The Committee recommends to the Department to intensify its approach to detect the HIV + children by targeting the HIV + mothers and ensuring full care and support to them. The Committee may be informed about the status of all HIV + children in India, State-wise.

12.5 The Committee is very concerned for the welfare of the HIV patients and their dependents. On a specific query regarding any initiative taken by the Department to come up with a rehabilitation policy for AIDS affected patients and their dependents, especially those of the weaker sections, in consultation with other Ministries/agencies, the Committee is informed that there is no scheme to provide rehabilitation to AIDS affected patients under NACP-III.

12.6 The Committee does not find the Department’s response to be a healthy one. Even if there is no such scheme under NACP - III, the Department can take up the idea further with other Ministries like Social Justice and Empowerment, Finance etc. In the opinion of the Committee providing financial security to the patients and their dependents will be a boon in Department’s fight against the epidemic and help in containing it. The Committee, therefore, strongly recommends to the Department to take a proactive approach in this regard.

XIII. INFORMATION EDUCATION AND COMMUNICATION (IEC)

13.1 The Committee appreciates the various interventions initiated for carrying out IEC campaigns, theme- wise campaigns for promoting HIV counseling etc., Multi-media campaigns, booklets for High Risk Groups etc. Red Ribbon Express, a specially designed exhibition train can be rightly considered as World’s largest mass mobilization against HIV/ AIDS. The Committee would, however, like to draw the attention of the Department towards reports received from time to time on the projected claims about successful treatment of HIV/AIDS. However, apprehensions were raised by some Members during the deliberation of the meeting as regards the presence of quacks coming up in the name of Indian medicines promoting that AIDS is 100 percent curable. The Committee was informed that the Department has very strong IEC component in their intervention for fighting HIV / AIDS. The Committee was apprised of the Red Ribbon Express Programme launched by the Department across the country, aiming at spreading knowledge and awareness about the disease. 13.2 The Committee is of the opinion that mere presence of statutory provisions for prohibiting quacks is not sufficient. The Committee strongly recommends that there is need to combat all such myths by providing the masses with the actual information in this regard by involving the State Governments.

OBSERVATIONS/RECOMMENDATIONS ---- AT A GLANCE

II. BUDGETARY ALLOCATION

There has been optimum utilization of allocated funds under NACP III so far. The only exception is that during 2008-09 inspite of marginal increase at the RE stage, pace of utilization at the end of the year was not very satisfactory with Rs. 91.00 crore remaining unspent at the end of the year. (Para 2.1)

The Committee appreciates that with focused intervention of NACO there is a considerable decline in unspent balances available with the Societies. The Committee would, however, like to point out that availability of unspent balance with some SACS, like Karnataka SACS (Rs. 11.34 crore), Tamil Nadu (Rs. 8.40 crore) and West Bengal (Rs. 8.99 crore) is still quite high. The Committee, therefore, recommends to the Department to introduce stricter monitoring mechanism and financial discipline so that funds do not get accumulated and remain unutilized. (Para 2.4)

The Committee would, however, like to point out that these efforts need to be sustained till the elimination of all the problem areas being faced by different States. The Committee is constrained to observe that there was downward revision of funds at the RE stage during 2009-10. The Committee does not find any merit in the justification put forth by the Department that across the board cut resulted in the downward revision of funds. In the Committee’s opinion, opening balance of Rs. 238.68 crore at the beginning of 2009-10 seems to be the main reason for reduction of allocated funds during the year. The Committee would like to point out that various components under NACP deserve to be pursued vigorously and any cut in funds for the same would severely hamper the ongoing fight against the deadly disease. (Para 2.6)

The allocation projected by the Department for 2010-11 was Rs. 1494.43 crore which was restricted to Rs. 1435.00 crore by the Planning Commission. Significant component of capital expenditure for establishing Blood Banks in 4 Metro cities, viz., Kolkata, Delhi, Mumbai and Chennai would be adversely affected as the allocated domestic budget support would not be available and the Department would be seeking enhanced allocation therefor. (Para 2.7)

III. ROLE OF NGOs

The Committee is dismayed to note that even after about two years, the Department has not been able to recover the unspent funds available with the discontinued NGOs. There appears to some slackness on the part of the Department and the other implementing agencies. Further, the fact that the Department has information only from 13 States, is an indicator of poor monitoring and control. The Committee would, accordingly, like to have a complete updated status till 2009-10 on this inter-alia containing the issues like contract norms fixed for NGOs, their selection criteria, number of blacklisted/discontinued NGOs - State-wise alongwith officials in the Government set-up held responsible, if any, for poor monitoring/selection, unspent funds available with such NGOs, amount recovered and the reasons for delay in recovering the same. The Committee would also recommend imposing severe penalties on NGOs which indulge in fraud or financial embezzlement. (Para 3.2)

The Committee apprehends that the discontinued/blacklisted NGOs may also resurface again by changing their name or place of work. The Committee would like to be apprised about the specific steps taken by the Department to thwart any such attempts by such NGOs and share with it such instances, if any, when it has been successful in preventing re-entry of such NGOs in the NACO network. (Para 3.3)

The Committee observes that achievement level of various components under NACP during the first three years of the Eleventh Plan period has been more or less satisfactory. Significant achievement has been reported under treatment of new STI cases and persons living with HIV/AIDS, setting up of ART Centres, Community Care Centres and Integrated Counselling and Testing Centres. However, the same cannot be said about other components. Against 220 lakh persons to be counseled and tested at the ICTC every year, target has remained between 46.00 lakh to 85.00 lakh and that too, has remained unaccomplished. (Para 3.4)

The Committee is constrained to observe that the achievement level under many of the physical targets set during 2009-10 has been far from satisfactory. There are instances of severe under- achievements under the components like - Setting new core group targeted interventions; setting up new bridge population targeted interventions; setting up new Blood Component Separation Units; setting up new District Level Blood Banks etc. The Committee fails to understand that under such circumstances how the Department has utilized more than 98 % of the funds during 2009-10 without achieving the satisfactory level of achievement under many of the physical targets. The Department needs to understand that it is good to achieve financial targets but what is more important is that achievement of the financial targets should be commensurate with the achievement of the set physical targets. The same is apparently missing here. Under such circumstances, the Committee has serious doubts over the planning and the subsequent execution strategies of most of the components of the Programme. The Committee can only infer that either the funds sought have been miscalculated or the Department has pumped in more money under certain components running successfully whereby it could show a higher percentage of utilization of allocated funds. The Department needs to clarify the same. (Para 3.5)

IV. SETTING UP OF NEW BLOOD COMPONENT SEPARATION UNITS (BCSUs)

The Committee is constrained to observe that the data made available to the Committee through the response to a query made twice reveals that the Department has fixed a target of 162 for setting up of new Blood Component Separation Units by the end of the Eleventh Plan. The Committee notes that no target was fixed for the first year, i.e., 2007-08, and for 2008-09 and 2009-10, 40 BCSUs each were kept as targets. However, a cumulative achievement of only 47 BCSUs could be made till February 2010. Out of the total target of 162 units for the Eleventh Plan period, a total of 115 more such units are required to be set up during the last two years of the Eleventh Plan period. The Committee would like the same to be clarified. (Para 4.2)

V. SETTING UP OF NEW DISTRICT LEVEL BLOOD BANKS

The Committee is dismayed at the fact that the Department has not been able to take up the matter of setting up of the district level blood banks with a sense of urgency. The Department itself is aware that these 39 Blood Banks have been identified on the basis of an assessment of urgent requirement in underserved areas. Hence, a delay in setting up of the blood banks as envisaged, is against Department’s obligations to see that the facilities reach these underserved areas. Most of the reasons cited for the delay are non-availability of adequate infrastructure, manpower and delay in issuance of license. The Department needs to play a pro-active role by taking up the matter with the concerned State Governments as well as the agencies at an appropriate level to expedite the procedural formalities. The Department should also consider providing appropriate additional funds, if required, for infrastructure and manpower related matters so that there is no delay due to financial constraints. (Para 5.3)

The Committee also recommends to the Department to take special notice of the underserved districts of Uttar Pradesh and Jharkhand. The Committee also hopes that the Department would keep on assessing the requirements of Blood Banks based on actual needs in various States due to migration and other issues. (Para 5.4) The Committee welcomes this new initiative of the Department for establishing four Metro Blood Banks as Centres of Excellence. However, the Committee is unhappy to note the slow progress of the Department in realizing this initiative which has been pending since 2008-09. These blood banks would not only act as model blood banks with latest equipments and technology but would also be of great help in meeting the ever rising demands of these metro cities. The Committee however notes from the records available with it that no deadlines have been set regarding making the same functional. Keeping in mind the delay already made in implementation of this initiative, the Committee recommends to the Department to have a targeted approach in making the four metro blood banks functional at the earliest. The Committee would also like to draw the attention of the Department to the undue delay in the operationalisation of model Blood Bank at Tirupati. Infrastructure for the Blood Bank has already been provided by the State Government. The Secretary assured the Committee that action for sending the equipment for the Blood Bank would be taken immediately. (Para 5.7)

VI. INTEGRATED COUNSELLING AND TESTING CENTRES (ICTC) The Committee is not convinced with the evasive reply of the Department. In the opinion of the Committee, while fixing targets for some component, one has to realistically assess all the hurdles/problem areas vis-a-vis the abilities of the system to deliver and achieve the same. Before fixing a target the Department should have taken into account all the relevant factors. Low level of institutional delivery being cited as the negative factor amounts to criticizing its own planning. (Para 6.3) This needs focused attention of the Department, since the Department has itself informed the occurrence of rising trends of HIV prevalence among pregnant women in the low prevalence/ vulnerable States of North India. The Committee is of the opinion that the Department can hope for achieving the set targets by proper planning and execution. It needs to strengthen its network of ICTCs and focus on strong Information, Education and Communication activities in such States to motivate institutional deliveries. (Para 6.4)

VII. PERSONS TO BE COUNSELED AND TESTED AT ICTCs (Target of 220 lakh per year) The Committee is happy to note that the quality issues related to HIV test kits have been resolved. The Committee hopes that the Department would keep a close monitoring of the quality related aspects of the kits so that such problems do not recur. The Committee also appreciates that some concrete steps have been taken to solve the issue of shortage of lab technicians by way of revising the guidelines of NABL. The Committee hopes that with concerted efforts like these, the Department would see an increase in the achievement level. (Para 7.4)

VIII. ART CENTRES

The Committee is satisfied that at present the number of patients undergoing second line of ART is within the manageable range. However, the Committee is of the considered opinion that the number of Centres of Excellence being limited to just 10 where the patients can have treatment facilities, the patients, especially the poor people residing far away from these Centres, will have to spend a lot of money for transportation for visiting these Centres regularly. The Committee thinks that with the facilities of ART Centres expanding, more number of patients requiring second line of treatment is going to increase considerably. Accordingly, the Committee recommends to the Department to have a realistic assessment of the requirement of new Centres of Excellence with a view to make the facilities for treatment available within reasonable distance of the patients. (Para 8.3)

IX. NEW INITIATIVES

The Committee is pained at the slow progress in establishing the National Blood Transfusion Authority and setting up of a Plasma Fractionation Plant. Both these initiatives are very important. It is very disappointing that the same still remains on paper even after two years. The Committee would like to be informed about the reasons for the inordinate delay and the deadline by which the same would be set up. It recommends to the Department to make all conceivable efforts to achieve the aforesaid targets at the earliest. (Para 9.2)

X. ADOLESCENCE EDUCATION PROGRAMME (AEP)

The Committee is happy to note that the Department in collaboration with the Ministry of Human Resource Development (MHRD) has been able to allay the apprehensions of many of the States w.r.t. implementation of the Programme. The Committee fully shares the concerns of the various State Governments regarding suitability of the contents of the Programme due to various demographic and cultural diversities that exist in the country. However, the Committee is of the opinion that the Programme, which aims at generating awareness amongst adolescents under its preventive strategy, is the need of the hour against this deadly disease. With changes in the study material and new modules already introduced under the revised AEP which take care of the concerns of the States, the Committee hopes that the Department needs to make concerted efforts alongwith MHRD to bring the remaining States on board where the Programme is still under suspension. The Committee may be informed about the efforts made by the Department in this regard. (Para 10.3)

XI. NEW STRATEGIES

The Committee is happy to note the progress made with regard to the new initiatives started in 2009-10. The Committee is of the opinion that setting up of the District AIDS Prevention and Control Units would fill up the necessary gap required as a supportive structure below the State level to coordinate the activities at the district level. The Committee would recommend expanding the same to more districts in the near future so as to implement the Programme effectively. (Para 11.5)

The Committee notes that the Link Work Scheme is an intensive rural-based intervention reaching out to the marginalized groups which remain uncovered even after the expansion of urban based prevention programmes. However, the Committee notes that the same is being implemented only in 18 States as of now. The Committee recommends to the Department to assess the need to cover the remaining States and closely monitor the scheme as the success of this scheme is crucial for achieving the goal of halting and reversing the epidemic of AIDS. (Para 11.6)

The Committee welcomes Department’s collaboration of its various activities with the backbone of India’s healthcare delivery system in rural areas - the NRHM. The Committee hopes that the Department would keep in close touch with the Department of Health and Family Welfare and explore more avenues to use its infrastructure and manpower under NRHM to further its various activities. (Para 11.7)

The Committee hopes that the Department would expand the preferred private provider scheme for management of sexually transmitted infections among high risk groups from existing 11 States to all the States having High Risk Groups in 2010-11. However, the Committee recommends close and strict monitoring of the scheme as the numbers may be fudged by the provider to get the token amount of Rs. 50 which is being given as consultation. (Para 11.8)

XII. NATIONAL PEDIATRIC INITIATIVE

The Committee is very concerned at the increasing number of HIV+children and rising trend of HIV prevalence in pregnant women in low prevalence/vulnerable States of North India. However, the Committee considers it to be due to Department’s proactive approach in identifying and tracking the HIV+mothers or it may be an indication of rise of the disease in the low prevalence States. The Committee would recommend to the Department to keep a strict vigil on rising trends of HIV prevalence among pregnant women in low prevalence States and take immediate steps to contain the same. The Committee may be informed of the specific steps taken by the Department in this regard. (Para 12.3)

The Committee is pained to imagine the plight of the small children who would be requiring the ART treatment in the long run. The Committee recommends to the Department to intensify its approach to detect the HIV+children by targeting the HIV+mothers and ensuring full care and support to them. The Committee may be informed about the status of all HIV+children in India, State-wise. (Para 12.4)

The Committee is very concerned for the welfare of the HIV patients and their dependents. On a specific query regarding any initiative taken by the Department to come up with a rehabilitation policy for AIDS affected patients and their dependents, especially those of the weaker sections, in consultation with other Ministries/agencies, the Committee is informed that there is no scheme to provide rehabilitation to AIDS affected patients under NACP-III. (Para 12.5)

The Committee does not find the Department’s response to be a healthy one. Even if there is no such scheme under NACP - III, the Department can take up the idea further with other Ministries like Social Justice and Empowerment, Finance etc. In the opinion of the Committee providing financial security to the patients and their dependents will be a boon in Department’s fight against the epidemic and help in containing it. The Committee, therefore, strongly recommends to the Department to take a proactive approach in this regard. (Para 12.6)

XIII. INFORMATION EDUCATION AND COMMUNICATION (IEC)

The Committee appreciates the various interventions initiated for carrying out IEC campaigns, theme- wise campaigns for promoting HIV counselling etc., Multimedia campaigns, booklets for High Risk Groups etc. Red Ribbon Express, a specially designed exhibition train can be rightly considered as World’s largest mass mobilization against HIV/ AIDS. The Committee would, however, like to draw the attention of the Department towards reports received from time to time on the projected claims about successful treatment of HIV/ AIDS. However, apprehensions were raised by some Members during the deliberation of the meeting as regards the presence of quacks coming up in the name of Indian medicines promoting that AIDS is 100 per cent curable. The Committee was informed that the Department has very strong IEC component in their intervention for fighting HIV/ AIDS. The Committee was apprised of the Red Ribbon Express Programme launched by the Department across the country, aiming at spreading knowledge and awareness about the disease. (Para 13.1)

The Committee is of the opinion that mere presence of statutory provisions for prohibiting quacks is not sufficient. The Committee strongly recommends that there is need to combat all such myths by providing the masses with the actual information in this regard by involving the State Governments. (Para 13.2)

MINUTES

VIII EIGHTH MEETING (2009-10)

The Committee met at 11.00 A.M. on Tuesday, the 6th April, 2010 in Room No. 139, First Floor, Parliament House Annexe, New Delhi. MEMBERS PRESENT 1. Shri Amar Singh ------Chairman RAJYA SABHA 2. Shrimati Viplove Thakur 3. Dr. Radhakant Nayak 4. Shri Janardan Dwivedi 5. Shrimati Brinda Karat 6. Shrimati Vasanthi Stanley LOK SABHA 7. Shri Ashok Argal 8. Shrimati Sarika Devendra Singh Baghel 9. Dr. Chinta Mohan 10. Dr. Sanjay Jaiswal 11. Shri S.R. Jeyadurai 12. Dr.(Shrimati) Kruparani Killi 13. Shri N. Kristappa 14. Dr. Tarun Mandal 15. Dr. Jyoti Mirdha 16. Shri R. K. Singh Patel 17. Dr. Anup Kumar Saha 18. Shrimati Meena Singh 19. Dr. Arvind Kumar Sharma 20. Shri Ratan Singh REPRESENTATIVES FROM THE DEPARTMENT OF AIDS CONTROL 1. Shri K. Chandramouli, Secretary 2. Ms. Aradhana Johri, Joint Secretary 3. Dr. S. Venkatesh, DDG 4. Dr. Mohd. Shaukat, ADG 5. Dr. Neeraj Dhingra, ADG

* * *

* * *

SECRETARIAT Shrimati Vandana Garg, Additional Secretary Shri R. B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Assistant Director Shri Satis Mesra, Committee Officer

2. At the outset, the Chairman welcomed Members to the meeting and informed them about the agenda of the meeting, i.e., examination of Demands for Grants (2010-11) of the Ministry of Health and Family Welfare and taking oral evidence of the Secretaries of the Departments of Health and Family Welfare (NRHM Sector), Health Research and AIDS Control in connection therewith.

3. * * *

4. * * *

5. * * *

6. * * *

7. * * *

8. * * *

9. * * *

10. Thereafter, the Committee took oral evidence of the Secretary and other officials of the Department of AIDS Control on the Demand for Grants (2010-11) pertaining to the Department.

11. A power-point presentation of the activities undertaken, achievements of the Department during the last year and plans for the current year on various schemes and programmes for preventing and reducing HIV/AIDS undertaken by the Department was made. Members sought clarifications on the activities and achievements of the Department and deliberated on the adequacy or otherwise of budgetary allocations under different heads, manpower and infrastructure available with the Department. The Secretary and other officers of the Department replied to a few queries raised by the Members and assured to furnish detailed written replies to those queries, which remained unanswered, within a week’s time.

12. A verbatim record of the proceedings of the meeting was kept.

13. The Committee then adjourned at 5.15 P.M.

IX NINTH MEETING (2009-10)

The Committee met at 5.00 P.M. on Monday, the 26th April, 2010 in Room No. '63', First Floor, Parliament House, New Delhi.

MEMBERS PRESENT

1. Shri Amar Singh ------Chairman

RAJYA SABHA 2. Dr. Prabhakar Kore 3. Shrimati Brinda Karat

LOK SABHA 4. Shrimati Sarika Devendra Singh Baghel 5. Dr. Chinta Mohan 6. Dr. Sanjay Jaiswal 7. Dr.(Shrimati) Kruparani Killi 8. Dr. Tarun Mandal 9. Shri Datta Meghe 10. Dr. Jyoti Mirdha 11. Shri R.K. Singh Patel 12. Shri M. K Raghavan 13. Shri Ratan Singh

SECRETARIAT Shrimati Vandana Garg, Additional Secretary Shri R. B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Assistant Director Shri Satis Mesra, Committee Officer

2. At the outset, the Chairman welcomed Members of the Committee and apprised them of the agenda of the meeting, i.e., consideration and adoption of draft 39th, 40th, 41st and 42nd Reports on Demands for Grants (2010-11) pertaining to Departments of Health and Family welfare AYUSH Health Research and AIDS Control, respectively. He invited Members to share their specific suggestions for improvements and incorporation in the Draft Reports. * * *

3. The Committee then discussed the four draft Report. A few changes were suggested by Members for incorporation in the Reports. After some discussion, the Committee adopted all the four Reports with some modifications. The Committee, thereafter, decided that the Reports may be presented to the Rajya Sabha and laid on the Table of the Lok Sabha on Wednesday, the 28th April, 2010. The Committee authorized Dr. Prabhakar Kore and in his absence Shrimati Brinda Karat to present the Reports in Rajya Sabha, and Dr. Jyoti Mirdha, and in her absence Shri Ratan Singh to lay the Reports on the Table of the Lok Sabha. 4. * * * 5. * * * 6. * * * 7. * * *

8. The Committee then adjourned at 5.50 P.M.