PARLIAMENT OF INDIA RAJYA SABHA 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 LOK SABHA ON 28TH APRIL, 2010) RAJYA SABHA SECRETARIAT NEW DELHI 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 NEW DELHI 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. Radhakant Nayak 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