World AIDS Day 2001
Men Make a Difference:
I Care.... Do You?

Formation of National AIDS Committee: Bangladesh has appreciably been very quick in responding globe wide possibility of HIV/AIDS epidemic. It was 1985 when the Government of Bangladesh formed a multi-sectoral National AIDS Committee (NAC) in response to the magnitude of the problem posed by HIV/AIDS epidemic worldwide. National AIDS Committee is virtually an advisory body with responsibility for major policy issues and strategies; co-operation and co-ordination of various sectors including NGOs; supervision of implementation of the programmes; and mobilization of resources. It is also a supervisory committee that provides guidance and formulates policy in relation to HIV/AIDS in Bangladesh.

Formation of Technical Committee: A Technical Committee (TC) was also formed composing of experts from relevant fields like medicine, social science, behavioural science and similar other disciplines to provide in-depth scientific, medical and technical advice to the NAC and the National AIDS Programme (NAP). The Technical committee (TC) is comprised of various specialists in fields relevant to the prevention and control of AIDS/STDs. The composition of the committee is continually reviewed to reflect needs as they arise. Important contributions of the TC include assisting the NAC to formulate programme frame-works; to guide programme personnel in the design, development and monitoring/reporting of their activities; and to review research protocols to be funded by the government (GOB).

Planning under GPA: In 1987, GOB decided to start AIDS prevention activities with the technical and financial assistance of WHO Global Programme on AIDS (GPA). In 1988, planned prevention activities began under a ‘Short Term Plan (STP)’, which focused on determining HIV/AIDS prevalence and in developing prevention and control measures, particularly in the health sector. During 1989, a 3-year ‘Medium Term Plan (MTP)’ was formulated and during the 90's, prevention activities were carried out with WHO support in areas of surveillance, laboratory diagnoses, and strengthening technical, financial, health education and management capabilities.

Formation of Coordination Committee: By the end of 1990, a Coordination Committee (CC) came into being, constituted by key functionaries from institutions already engaged in HIV/AIDS related activities. Responsibilities were assigned to each member as part of a programme building effort.

Formation and operationalization of AIDS Information and Awareness Campaign Committee: Under the leadership Ministry of Health and Family Welfare (MoHFW), the AIDS Information and Awareness Campaign Committee (AI&ACC), comprising of representatives from several Ministries, WHO, other donor agencies, media and NGOs, have conducted many activities in 1993 and 1994. Several IEC materials have been produced and distributed by this committee. Other activities have included social mobilization meetings, exhibitions and seminars in cities, towns and villages. Many media activities have focused on contexts in which people get involved in high-risk behaviours, as well as the public attitude and behaviour at large.

Early intervention: Till 1995, National AIDS Programme was mostly supported financially by World Health Organization (WHO) and tasks carried out by the Programme were sero-prevalence and point-prevalence studies, training and development of human resources, production and promotion of BCC/IEC materials, and creation of awareness among both general and high-risk behaviour practicing population.

Development of partnership with UNDP: It was in 1996 when UNDP has signed an agreement with the GOB to set up an infrastructure within GOB facilities for a comprehensive AIDS control programme known as UNDP funded TAPP on "Bangladesh AIDS Prevention and Control Programme (BAPCP)" which continued till 30^th June 1998. The Joint United Nations Programme on HIV/AIDS became operational in 1996 to work with Government, NGOs, the private sector, and donors to support the national response to HIV/AIDS.

Policy formulation and adoption: In appreciation of the complexity and gravity of the HIV/AIDS epidemic, the Director General of Health Services formed an 11 member "Task Force" to initiate the process of policy formulation in 1995. In October 1996, the national HIV/AIDS policy document was reviewed by a 19 member Core Group and examined by a multi-sectoral consensus workshop in which ten stakeholder groups participated. The resulting final document was approved by the cabinet in 1997. The government NAP management structure has been outlined in the policy document.

Development of safe blood protocol: In March 1997, a protocol for a safe blood transfusion service was submitted to the MoHFW by the Blood Transfusion Technical Sub-Committee of the NAC. Since 2000, 97 blood transfusion centres have been provided with blood screening facilities up to district level, some of which are in the private sector. These centres will screen blood for HIV, syphilis, malaria, HBV and HCV.

Currently, quite a number of laboratories have started to provide facilities to test for HIV in the country. Most are in the private sector. However, pre-, post- and follow-up counselling has yet to become an essential part of the process.

Prioritization of role of women: There are specific issues that AIDS brings to women. The disadvantaged and marginalized status of women in Bangladesh deprives them of access to information and intervention programmes on AIDS as well as, most importantly, negotiating power in matters of sexuality. In response, a Women Wing (WW) of the NAC was set up to raise and plan for such issues within the NAC and the National Programme. In the NGO sector, women are taking part in programmes addressing the wider socio-developmental issues of women as well as providing information and behaviour change support to women. NGOs are also making a start to promote male responsibility in matters of sexuality and family planning. The role of the man as a dominant partner in sexual decision-making is often forgotten, perhaps because of the perceived difficulties. However, this is an area that obviously requires focused attention if a NAP is to be successful.

Development of GO-NGO partnership: Non-Government Organizations have set up a STD/AIDS Network since 1996. It is broadly recognized that NGOs, given their potential for flexibility and interactive relations with community members, have much to offer towards prevention and behaviour change activities. Relevant to HIV/AIDS/STDs, close collaboration between GOB and NGOs is currently being addressed. NGOs are being invited to support the MoHFW with delivery of the Essential Services Package (ESP); interventions for community behavioural change; training and providing standard guidelines for the programme. Non-Government Organizations have been carrying out the major part of HIV/AIDS prevention activities nation-wide. From IEC/BCC, targeted interventions, to policy formulation, NGOs have been instrumental at all levels. Indeed, without NGO participation, Bangladesh would have undoubtedly been much further behind than it is at present.

Emergence of different forums: Furthermore, there is a network of media people (AIDS and Health Writers Group) and an AIDS and Legal Issues group (ALACAA). A successful consensus workshop was held in November 1995 to agree on the relative roles of GOB and NGOs towards HIV/AIDS prevention and control. In essence, NGOs have been given full support to complement GOB efforts and to take on activities that are beyond government's scope.

New UNDP programme: New UNDP funded programme, the Multi-Sectoral AIDS Preventuion Programme (MAPP) started in October 1998. Since then the major activities in this field have been carried out within this TAPP along with activities done from regular country budget allocation of WHO for similar purpose.

World Bank and other donor participation: In year 2000, a document was signed between GOB and World Bank for a soft loan of US$ 40 million for Strategic Implementation Plan (SIP) over four years period. The other contributor of this 4-year HIV intervention plan is DFID, who has a contribution of US$ 10 million.

Development at a glance: In brief, the HIV/AIDS prevention programme was initially started in December 1988 with technical and financial assistance from Global Programme on AIDS (GPA) through World Health Organization (WHO). Then many things happened subsequently. The calendar of events under this programme over the years is given below:

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