HIV/AIDS in Nepal - National Response

National Response

The NCASC coordinates Nepal's response to the HIV/AIDS epidemic. In 1992, the Government of Nepal founded the National AIDS Coordination Committee to lead the multisectoral response to HIV/AIDS and followed with the establishment of the National AIDS Council to oversee the Committee's efforts. However, both the Council and the Committee have been ineffective, in part because of civil strife.

Despite this fact, substantial progress has been made with respect to national commitment and a strengthened response to address the HIV/AIDS epidemic in the country. HIV and AIDS have been recognized as a priority in the new interim three-year development plan. The national program is implemented under one national HIV/AIDS action plan framework. A national monitoring and evaluation system has been developed, and the Government of Nepal has taken initial steps toward establishing a semi-autonomous coordination body for HIV and AIDS. There is strong civil society engagement in the response.

Given the nature of the epidemic in Nepal, most of the national initiatives have focused on leadership, partnerships and the involvement of civil society for prevention, care, and support for its most-at-risk populations. From 2003, the NCASC implemented the HIV/AIDS Operational Plan based on the National Strategy 2002–2006. Currently, the HIV/AIDS activities are shaped by the second National HIV/AIDS Strategy 2007–2011, and implementation is coordinated under the 2006–2008 National Action Plan, which has the following priorities:

• Preventing the spread of sexually transmitted infections (STIs) and HIV infection among at-risk groups;
• Ensuring universal access to quality treatment, diagnostics, care, and support services for infected, affected, and vulnerable groups;
• Ensuring a comprehensive and well-implemented legal framework on HIV/AIDS promoting human rights and establishing HIV/AIDS as a development agenda;
• Enhancing leadership and management at national and local levels for an effective response to HIV/AIDS;
• Using strategic information to guide planning and implementation for an improved effective response; and
• Achieving sustainable financing and effective utilization of funds.

The vision of the national strategy is to expand the number of partners involved in the national response and to increase the effectiveness of Nepal's response. It also emphasizes prevention as key for an effective response to the epidemic, particularly in areas with high levels of out-migration. The strategy includes care and support for people infected and affected by HIV/AIDS while recognizing the contribution of care and support to effective prevention. It also recognizes the importance of accurately tracking the epidemic to monitor the effectiveness of interventions.

Nepal's political instability has resulted in nominal government support for national HIV and AIDS programs. Therefore, most HIV/AIDS activities are funded by external development partners. Antiretroviral treatment (ART) coverage has increased from no free or publicly available treatment three years ago to 13 percent of those estimated to need ART accessing free treatment. ART drugs are provided through a grant from The Global Fund to Fight AIDS, Tuberculosis and Malaria. While there is a need to expand services further, several organizations provide community care and support services.

Nepal receives assistance from several international donor organizations, including The Global Fund and Great Britain's Department for International Development. The Global Fund approved a second-round grant in 2003 to support HIV/AIDS prevention among labor migrants and young people and to care for HIV-infected individuals. Nepal was also approved for a seventh-round grant in 2007 that will focus on labor migrants and target gaps in services for MSM and IDUs.