India’s HIV control programme could soon get merged with the country’s flagship National Rural Health Mission (NRHM), if the Planning Commission has its way.

The Commission’s steering committee on health for the 12th five-year Plan has proposed “incorporating AIDS control, universal healthcare and universal access to essential medicines” into NRHM.

Planning Commission member in-charge of health Syeda Hameed said, “It is a serious recommendation to incorporate NACO under an overall National Health Mission rather that a single vertical programme.”

The proposal, however, has left both the Union health ministry and the National AIDS Control Organization (NACO) unhappy.

Union health secretary P K Pradhan said, “We have told the Planning Commission that this recommendation cannot work. AIDS control is a specialized issue, and needs focused attention.”

Pradhan added that AIDS control cannot be carried out by Auxiliary Nurse Midwives (ANMs).

“Containing AIDS and HIV in India will require dealing with sex workers, injectible drug users, transgenders and men who have sex with men. It is a different clientele compared to the work that ANMs do now. We are not in favour of the merger,” Pradhan added.

Hameed, however, disagrees. She argued, “It’s all about training the ANMs on how to carry out AIDS control. We, however, don’t want to burden them too much. The steering committee report will undergo three levels of approval. We are confident of pushing it through.”

The steering committee report says “Impressive gains made by national health programs, including NRHM and other disease control programs, now need to be channeled to deliver Universal Healthcare in all urban and rural areas during the 12th Plan period.”

It adds, “The process should start during the first year of the plan itself with Universal Healthcare pilots being run in one district of each state and UT. Concurrently, the management structure of national health programmes needs to take steps to prepare for UHC. Key recommendations on this transition is reorienting from vertical disease based approach to a holistic, health promotion strategy based on strengthening of health systems.”

The panel says the B K Chaturvedi Committee on Restructuring of Centrally Sponsored Schemes has also recommended merger of individual disease control programmes.

“The NRHM governance structure should be used to provide leadership to all the national health programmes. Operations under national disease control programmes should be harmonized under NRHM so as to avoid duplication and provide convergent services in a cost-effective manner,” the report says.