COUNTRY PRESENTATION (DRUGS AND HIV/AIDS)– Nepal Dr. Krishna Kumar Rai, Director National Centre for AIDS and STD Control, Ministry of Health and Population

National structures in response to HIV/AIDS  National AIDS Council (NAC) headed by the Prime Minister  National HIV/AIDS and STI Control Board (HSCB)  National Centre for AIDS and STD Control (NCASC) headed by a Director (under Ministry of Health and Population)  HIV/AIDS program is P1 program /integrated program  District AIDS Coordination Committees (DACC) in 75 districts, DHO is the secretariat of DACC

HIV situation in Nepal, 2011  Total HIV infection reported as of 17 September, (Male-11964, Female-6571)  Heterosexual transmission is predominant-- More than 80% infections are spread through sexual transmission  Injecting drug users, female sex workers and their clients, MSM, mobile and migrant popn are the key sub populations are the most at risk population - driving the epidemic

Injecting Drug Users Profile and behavioural characteristics  Estimated number – 33, 742  61.6% aged between years  59.6 % unmarried  41.7% have completed 10 or more years of schooling  Prevalence of HIV among IDU in Kathmandu Valley is 6.3% and 4.6% in Pokhara

 Narcotic policy (because of HIV transmission related components-harm reduction) has been recognised and mainstreamed in MOHA policy and related strategy (i.e. Drug Control Strategy 2010).  Emphasis is given on reducing stigma and discrimination in all related activities— sensitization, awareness campaign. Narcotic Policy

Ongoing Country Efforts National Drug Control Policy -operational New Drug Control Law - upcoming Drug Control Strategy -endorsed The Guidelines for rehab centres -operational OST Guideline is on the final stage-under translation

Ongoing Country Efforts  Implementing the National HIV/AIDS Strategy  Health System strengthening for treatment, care and support –under GFATM support/pool fund capacity development, training –under implementation.  Community System Strengthening- under implementation, HIV prevention, community care support programs in partnership with civil society --- funded by Global Fund Round 7, Global Fund Round 10 and through Sector Wide Approach –supported by pooled partners (World Bank, DFID, AusAID)

Contribution of the project in the National response  Coordination in setting up Harm Reduction & Methadone Maintenance program and ensuring a smooth transition to a government led mechanism supported by Global Fund and Pooled Funds  Technical partnership in involving civil society, IDU network in terms of HIV prevention of transmission,  Direct service to over 8000 IDUs through, Comprehensive Harm Reduction services and Methadone Treatment  Advocacy for conducive policy environment to drug users in the country  Overall coordinating role between the Ministry of Home Affairs and Ministry of Health and Population

Way Forward  Collaboration- strengthen regional cooperation through knowledge & experience sharing  Develop Regional Harm Reduction Policy, Strategy and advocacy guidelines  Provide lead TA role in research as well as in program development in terms of new dynamics among adolescents and young drug users (under 18)  Explore and invite new donors in the South east Asia region with the changing economic context,----- economically rising country like China (also high prevalence of HBV)

THANK YOU