EXECUTIVE SUMMARY

The existence of HIV/AIDS/STD poses a serious challenge to human kind. To date, there is neither a vaccine nor a cure for AIDS. It is now well known that the presence of STDs predisposes the individual to HIV infection. Unfortunately, many STD cases go undiagnosed and untreated.

HIV/AIDS is a human development problem fueled by poverty, the inequality of certain sectors of society, and the presence of other STDs. As a result, the socio-cultural, economic as well as health determinants of the transmission of HIV/AIDS/STD must be addressed. In formulating a national policy for HIV/AIDS and STD related issued, the need arises to incorporate the above as policy concerns as part of an action strategy for future programmes.

A National Policy Document on HIV/AIDS and STD, under the auspices of the Bangladesh STD Prevention and Control Project, was compiled by a ‘Task Force’ in early 1995 with the Chairman of the Technical Committee of the National AIDS Committee as its convener. Its limitation lay in the fact that it could not delve into all the issues with purported authority. This led to the formation of a ‘Core Group’ drawn from all disciplines of the social health strata. The group held a ‘Multi-Sectoral Consensus’ Workshop using Visualization in Participatory Planning (VIPP) method on 8 & 9 October 1996 in which various stakeholder groups participated. The participants reviewed and recommended necessary amendments and additions to the National Policy Document which are reflected in this final draft.

Four Cross-cutting and priority issues were given emphasis in the document. These were human rights, gender, behaviour and information, education and communication (IEC). The modern human rights movement envisaged in the Universal Declaration of Human Rights (UDHR) offers public health a previously unavailable instrument and approach for analyzing and responding to the societal dimensions of the vulnerability to HIV/AIDS/STDs. Gender receives an increasingly important dimension as women will account for almost half of all the HIV infections by the year 2000. One cannot proceed with a HIV/AIDS/STD policy by delinking women’s and men’s reproductive and behaviural health issues.

Over the last few years, there has been as attempt to differentiate between ‘high risk group’ and ‘high risk behaviour’. Focusing attention on behaviour has proven more effective, because it targets all who are vulnerable. AIDS information, education and communication is an important strategy for HIV/AIDS prevention. The use of powerful media –both electronic and print –must be augmented to present balanced, informative and well judged news. Media must shun prejudices and value judgments in line with fundamental human rights and shape educative efforts to produce its impact on behavioural changes.

The policy statement endorses the Universal Declaration of Human Rights (UDHR) as a standard for policy making and action at all levels in the response to HIV/AIDS and STDs in Bangladesh. All the fundamental principles enshrined in the text of UDHR are to be followed in pursuance of policy making.

As regards the HIV/AIDS/STD Prevention and Control Programme, certain objectives and strategies have been delineated. Among the objectives are to:

a) prevent HIV transmission;

b) reduce the impact of HIV/AIDS on the individual and the community;

c) prevent transmission of STDs; and

d) provide STD management.

Among the strategies are:

a) prevention of sexual transmission;

b) prevention of transmission through blood and blood products;

c) prevention of parenteral transmission;

d) prevention of vertical transmission from mother to child; and

e) reduction of the impact of HIV infection on individuals, communities and the societ

To carry out these specific objectives and strategies, the national programme has been assigned to several task formulating bodies with individual membership make-up and terms of references. The committees are:

National AIDS Committeen

A multi-sectoral body with a strong political commitment. It is an advisory body to the Government of Bangladesh which oversees all the aspects related to HIV/AIDS and STDs.

Technical Committee of the National AIDS Committee

The Technical Committee is a body of experts supervising technical aspects of HIV/AIDS/STD prevention and control and is the technical arm of the National AIDS Committee. In addition the Technical Committee provides technical support to the Coordination Committee.

Co-ordination Committee

This group or body performs as the link to the tripartite coalition of NAC, MOH&FW and DGHS for smooth functioning in policy formulation and implementation. It consists of coordinators of surveillance, counselling, health education, blood transfusion, sterilization, nursing, case management, laboratories, primary health care and reproductive health services.