Minister for Population and Health RAJENDRA MAHATO is one of the known politicians with capacity to work. After taking the charge of the Ministry of Population and Health, minister Mahato, a leader of Madhesh based party- Nepal Sadbhavana Party- has already started to clean up the health sector institutions, including the country’s old Bir Hospital. As Nepal is celebrating the world HIV/ AIDS day, minister Mahato spoke to KESHAB POUDEL on government policies on HIV/AIDS. Excerpts:


What is the strategy of the government on HIV/AIDS in the context of celebrating the World AIDS day?

As this year’s World AIDS Day slogan ‘Getting to Zero - Zero New HIV Infections. Zero Discrimination and Zero AIDS Related Deaths,’ the government is directing all its programs towards these goals. Our national policy and program is guided by National Policy on AIDS and STD 2011. We will activate the National AIDS Council, National HIV/AIDS and STI Control Board and National Center for AIDS and STD Control (NCASC).


What are your special efforts?

Our effort is to ensure universal access to quality treatment, diagnostics, care and support services for infected, affected and vulnerable groups in Nepal within a context of a comprehensive response to HIV and AIDS.


What about the resources?

Of course, there is always a scarcity of resources in the health sector. So far as the funding for HIV/AIDS is concerned, we have good money. We have already spent a lot of resources to increase national capacity to provide quality diagnostic, treatment and care services, increase availability of appropriate and differentiated care and support services to infected, affected and vulnerable population. One of the positive sides is that we have increased involvement of private sectors, civil societies, communities and family for treatment, care and support to the infected and vulnerable groups.


What about the state of funding?

We don’t have problems with funding. Nepal’s development partners, particularly UNAIDS, has been playing a very important role in supporting the government agencies to enhance their capabilities. We have also received funds from Global Fund and other multilateral and bilateral agencies. There is the need to have certain coordinated approach to use the resources to get optimum results. These approaches will be continued by the government through financial support from the Pool Fund partners, Global Fund for AIDS Tuberculosis and Malaria (GFATM), USAID and other donors.


What are the challenges?

Despite success, increased access to quality treatment, diagnostics, care    and    support    for    ART,    STI and  OLs Stigma    and    discrimination  reduction are some challenges. Community and Home Based Care, Pediatric Care (Including    Orphan    and    vulnerable    children),   Impact    Mitigation   Program are others. Yet other challenges include prevention and clinical    management of HIV/AIDS related illnesses and expansion of Antiretroviral therapies Management of  HIV  related  co-infections.


How serious is the government about HIV/AIDS epidemic?

One of the achievements of our HIV/AIDS program is that we are able to stabilize the HIV. As you know, Nepal is described as having a “concentrated” HIV/AIDS epidemic, with by far the highest prevalence rates among high risk groups (or Most At Risk Populations, MARPs) such as labor migrants, injecting drug users (IDUs), men who have sex with men (MSM), female sex workers (FSW) and their clients. Labor migrants currently account for about 30% of all HIV infections as a significant proportion of their population has unprotected sex with multiple partners while abroad in (most commonly to India).


What is the government doing for the future?

As agreed by the world leaders, who gathered in New York for the 2011 United Nations High Level Meeting on AIDS, we are working to develop a strategy as expressed in Global Plan to gain significant strides towards eliminating new HIV infections among children by 2015 and keeping their mothers alive. Preventing new HIV infections among children in Nepal is very important as that saves lives and prevents the infection to the children.


What is the state of pregnant women?

Providing pregnant women living with HIV with antiretroviral prevention and treatment is very important as it will reduce the risk of a child being born with the virus.  We can only achieve a generation free of HIV and AIDS by focusing our efforts on the mothers and children at greatest risk and in greatest need.  We need to focus on a series of specific policy and programmatic measures which ensure that all pregnant women living with HIV have access to HIV prevention and treatment services and that new HIV infections among children are eliminated by 2015.


What is the state of HIV now?

HIV and AIDS epidemic has evolved from low and now it is concentrated among High Risk Groups, injecting drug users, female sex workers, clients of female sex workers, men who have sex with men and labor migrants. Heterosexual transmission is dominant. Total HIV infection reported as of 17 September, 2011 was 18,535 with 11,964 males and 6,571 females.  The recently released Integrated Biological and Behavioral Surveillance (IBBS) surveys 2011 also indicate that the targeted intervention approaches among most-at-risk populations, designed by the Government of Nepal, are successful in preventing HIV and STI infections and contribute to achieving overall success of the HIV and AIDS response in the country.


Do you have any special plan for the future?

In collaboration with all stakeholders, NCASC is committed to further strengthening the national HIV response and extending services to those not yet reached so that these positive results can be sustained and improved. We are also stressing to take the leadership by district health managers in the fight against HIV and AIDS so as to achieve the Millennium Development Goals (MDG-6) by 2010.


It is said that frequent political interventions is causing problems in dealing with HIV. How do you look at this?

I don’t think there is frequent political intervention. The transfers are made as per the requirement of departments. The ministry has given full authority to NCASC for coordinating and managing HIV/AIDS epidemic and STI control in the country.

Where is the government focusing its attention now?

The government is focusing its activities in increasing service coverage to reach Most-At-Risk-Population (MARP) of the country, minimize transmission of HIV and provide treatment, care and support services to the people living with HIV who are in need. Nepal has gained enough momentum in managing HIV services to the people of the country. The government alone cannot achieve such a big target. It needs support from civil society, Nepal’s donor partners and private sector also.