The Catholic Health Association of India (CHAI) has been involved with HIV/AIDS-related work since 1992 carrying out various activities through its 3271 Member Institutions (MIs). Formulating a Policy on HIV/AIDS as early in 1994, CHAI started work, aided and guided by a “think-tank”. The Action Plan on HIV/AIDS is being implemented since 1994 in a phased manner; currently it is in Phase-IV. And the focus is on developing the capacities of Member Institutions to effectively and efficiently carry out their tasks.
Realizing that confronting and reining in the pandemic would be a huge task, we started to work on a collaborative mode — planning and strategizing together with like-minded, competent and committed organizations like Catholic Medical Mission Board, World Vision India, Catholic Relief Services, Bill Gates and Melinda Foundation, Georgetown University, USA, Bloomberg University, Toronto, Canada, Italian Bishop’s Conference, Misereor, People’s Health Assembly, National AIDS Control Organization, Andhra Pradesh State AIDS Control Society, Sisters of St John the Baptist, Camillus Fathers, and Catholic Health Association of India (CHAI).
Today, the organization is implementing 8 Structured Projects that are broadly classified as ‘Interventions with focus on Community Health, Communicable Diseases (mainly HIV/AIDS) and Disaster Interventions.
The Centre of Excellence is on its way to fruition. Various constituent parts of it are being put in place. The idea of the Centre of Excellence is neither a fancy or abrupt one. It has been necessitated by various ground realities that exist in the health care scenario today. It has a history behind it.
Four years ago in October, 2004, Dr G D Ravindran and Rev Dr Sebastian Ousepparampil visited an HIV/ AIDS Centre in Warangal, a Care Centre with 30 beds. There, each patient was being helped by a family member. Their interaction with the Care Centre revealed that they were lagging behind in their knowledge about the treatment pattern, administration of drug regime etc. If that is the situation prevailing in a HIV/AIDS Treatment Centre close to Hyderabad, what will be the state of affairs of a treatment centre located in far-flung corners of the country?
Most of our member institutions (MIs) function in medically under-served areas of our country with inadequate resources, infrastructure and trained personnel. They are either health centres or small hospitals, majority of whom do not have a visiting doctor which is a minimum requirement. And many of the Health Centres do not have the facility for ‘standing orders’ and ‘continuing medical education.
All these can be made possible through the Centre of Excellence with the IT Revolution in our midst. As you understand, the treatment pattern in HIV/AIDS is rapidly changing. The staff, especially the sisters, are willing and committed to work reaching out to as many people as possible but constraints incapacitate them. The harassment meted out by authorities, especially the police, under various pretexts also demoralize them which affects their functioning. There is a crying need to support them through giving them access to expert advice, latest information and technology and upgrade of skills.
The paradigm shift that is taking place in the health care delivery scenario also makes most of our member institutions hard to survive. They fail to cope with the changing scenario. Health care is slowly but surely turning into a booming industry. Service-oriented institutions, especially those in the voluntary sector, find it difficult to function any longer. Globalization, inequality and poverty impact society so much that life becomes hard for people in the lower strata. Health care gets denied to them as they cannot buy it from corporate hospitals which cater to the rich and those belonging to the upper strata. Worldwide, 1000 million people each year are impoverished by paying for healthcare, according to a WHO report.
Today, every global activity is guided by re-equipment, reorientation and innovation and supported by cutting edge technology. It is imperative that we also update, re-orient and re-equip ourselves in order to deliver the goods. We have several ongoing global programmes. All the programmes need technical expertise, sophisticated infrastructure, highly competent personnel and resources. Following conventional means and methods, those programmes can never make any impact. And we find ourselves in a ‘innovate or perish’ situation. We need the best as regards technology and personnel. For involving in activities related to communicable disease, especially HIV/AIDS, we need cutting-edge facilities and competent personnel which come at a price and adequate financial resources.
All the learning’s developed from an observation of the ground realities spurred us to seriously think of innovation which led to the concept of the Centre of Excellence. The idea of the Centre of Excellence went through various brain-storming sessions as well as discussions at various levels and with different groups. The historical launch of the venture was initiated with the laying of foundation stone on 8th of December 2007. The Centre is envisaged as a cluster of manifold services delivered from under one roof. Centre of Excellence is CHAI’s national-level effort to address needs related to research, training, diagnosis, counselling, prevention and care, support and treatment services in Community Health and Communicable Diseases.
The Centre aims to
- harmonize the national, state and church efforts in HIV/AIDS care
- increase efficiency of service delivery
- fill the existing gaps in the HIV/AIDS prevention care and treatment scenario
- act as a nodal centre for trainings and demonstration
Other components of the centre
- Community Care Centre / Training Centre
- Distance Mode of Education / Virtual Resource Library
- Clinical Consultation Hotline
Need for scaling up efforts
The findings of “Children and AIDS: Second Stock-taking Report” (very recently launched by UNAIDS, WHO and UNICEF) are worrying. Over 2.1 million children below the age of 15 are living with HIV/AIDS globally. Around 4.2 lakh children were newly infected in 2007; 2.9 lakh children under 15 died of AIDS; young people aged 15-24 account for forty per cent of new HIV/AIDS infections in 2007. The number of HIV positive pregnant women receiving antiretroviral therapy increased by sixty per cent. According to estimates, 4% of the 2.6 million estimated HIV/AIDS cases in India are children. India is on the verge of having the greatest increase in the estimated number of PLWHAs in the coming decades. With over 50 lakh PLWHAs, India currently has the world’s second largest number of cases. The National AIDS Control Organization (NACO) projects that there will be 90 lakhs HIV cases by 2010.
HIV/AIDS is wreaking havoc in the whole of Asia. According to UNAIDS and WHO estimates, 4.9 million people were living with HIV in Asia in 2007, including the 440,000 (210,000 – 1.0 million) people who became newly infected in that year. Approximately 300,000 (250,000-470,000) people died from AIDS-related illnesses in 2007. Overall, an estimated 9 million Asians have been infected with HIV since it first appeared in the region more than 20 years ago. Approximately 2.6 million men, more than 950,000 women — many of them in their 20s and 30s – and almost 330,000 children have died of AIDS-related diseases. It currently accounts for more deaths annually among 15-44 year old adults than do TB and other diseases. It is estimated that the pandemic will cause a total loss of 180 million years of healthy and productive life in Asia between 2002 and 2020.
Challenges remain in four key areas: Preventing HIV transmission from mother to child, providing paediatric treatment, preventing infection among adolescents and young people, and protecting and supporting children affected by the pandemic.HIV/AIDS infection progresses more aggressively in infants than in adults. This shows that our efforts to protectwomen and children need to be continuously scaled up and it has to be at the heart of HIV/AIDS agenda. As the pandemic goes about methodically decimating people across the globe and proving harder to be tackled, we need to confront it collectively and outwit the pandemic by arming ourselves with innovative approaches supported by sophisticated techniques and technology and adequate financial resources. Hence the need for collective ventures like the Centre of Excellence.
Snehakiran (Community Care Centre)
Snehakiran, the Community Care Centre, the prime component of the Centre of Excellence, would provide comprehensive communicable disease-related medical services. It would be a 65-bedded in-patient health facility with cutting-edge technology and state-of-the-art equipment. An advanced hospital management information system (MIS) will be its distinguishing feature.
The service offered include:
- Outpatient services , Inpatient services
- Outreach programmes , Infection control measures
- Referral/linkages with governmental and non-governmental institutions
Snehakiran will be a partnering endeavour by Sisters of St John the Baptist, Camillus Fathers and the Catholic Health Association of India (CHAI).
Key roles of the centre
- Link Member Institutions with national programmes
- Advocate the rights of PLWHAs and Care-and-Support-Centres
- Provide hands-on-training on Communicable Diseases with special focus on HIV/AIDS to the doctors, nurses and health care providers
- Offer Distance Mode of Education
- Undertake Accreditation of Nurse-practitioners
- Provide Standing Orders centrally on Community Health and Communicable Disease-Related issues
- Assure quality care in the Care and Support Centres