Speeches and Remarks 2006

As prepared for delivery

Remarks by David Hopper, U.S. Consul General in Chennai
Dissemination Meeting of USAID supported INDIACLEN Project
"Documenting Tamil Nadu Response to HIV/AIDS 1986 - 2005"
GRT Convention Center, Chennai.
June 23, 2006

Ladies and Gentlemen,

Good morning to all of you.  I am happy to be here to represent the US Government at this important event to mark the publication of this document that narrates Tamil Nadu's successful experience in combating HIV/AIDS.

In 1986, Tamil Nadu was in the public eye as the state with the first case of HIV infection in India.  In just two decades, the state has been able to demonstrate that with coordinated efforts and strong political commitment, we can make big strides towards stemming the tide against HIV/AIDS.  The epidemic in the state, which reached a high point of 1.13% in 2001, continues to decline and is now at 0.5%.  I congratulate the policy makers and all the implementing organizations for making this happen.
 
I would like to state my appreciation for the tremendous job that has been successfully undertaken by the Government of Tamil Nadu, and the Tamil Nadu State AIDS Control Society (TNSACS).  TNSACS has been the centre point for coordinating and driving the response of the Government and Civil Society. TNSACS has led the way in India as an example of how successful partnership is making a significant contribution in controlling the HIV/AIDS epidemic.  Many other states in India have and are continuing to learn from Tamil Nadu. At this juncture, I would like to recognize the contribution of the National AIDS Control Organization (NACO), which has spearheaded the HIV/AIDS prevention program in the country. They have provided the framework and necessary autonomy for State AIDS Control Societies, which has helped in decentralizing the program and enhancing the ownership of the state to support the implementation of successful projects.

The US Government has played an important role in health and developmental issues globally.  Through U.S. Agency for International (USAID) support to the National AIDS Control efforts in India dates back to 1992, when we signed an agreement with Government of India (GOI), to support HIV prevention and control activities in the state of Tamil Nadu through the AIDS Prevention and Control Project.  This project became a model of HIV prevention in the country and complemented the Government. of Tamil Nadu's HIV/AIDS prevention activities.  The Centres for Disease Control and Prevention of the US Department of Health and Human Services started their support to Tamil Nadu in 2002.  Their support to the Government Hospital of Thoracic Medicine, Tambaram, has resulted in a centre of excellence for ART training and management.  Other states are learning from these two successful initiatives. The two projects have worked very closely with the Government of Tamil Nadu and have created useful synergies. Other US based agencies have also made useful contributions to the HIV/AIDS epidemic in the state.
 
In 2003, President George W. Bush announced the $15 billion, US President's Emergency Plan for AIDS Relief (also called PEPFAR), the largest international health initiative by one nation to address a single disease.  India became a PEPFAR country in May 2005. Through this initiative, all US Government agencies work together to implement a single USG response, and leverage partnerships with the government, multilateral institutions, non-governmental organizations (NGOs) and the private sector, to implement effective programs in HIV/AIDS prevention, treatment, care and support.  PEPFAR aims to build the capacity of local leadership in the fight against HIV. Some of the strategic principles of the Emergency plan are: evidence-based decision making to develop programs suited to local needs and host government policies; comprehensive prevention to care continuum models; involvement of People living with HIV/AIDS in decision making; Public Private Partnerships; and capacity building of local organizations.

The progress we all have made in the last few years is phenomenal.  Correct knowledge on HIV/AIDS and safe sexual practices have increased.  We see a lot more engagement of the private sector in prevention and care and support activities.  ART drug prices have come down considerably, and this has transformed AIDS from an inevitable fatal condition to that of a manageable and treatable chronic illness.  

While we should take considerable pride in our progress to date, we cannot become complacent. There are still many major challenges ahead of us. Only a small percentage of those infected are aware of their HIV status and have been counseled on preventing further infection from them to their partners.  Stigma and discrimination of HIV-positive people and access to ART continue to be a major challenge.  Adherence to ART and tracking resistance to first line drugs are some of the challenges in HIV management.   Infection rates among youth and women are on the increase and appropriate strategies need to be evolved for reaching out to them at a faster pace.  Recent data shows an increasing prevalence among Men having Sex with Men (MSMs) and Injecting Drug Users (IDUs), which is a cause of concern. We need to collectively review which approaches worked and did not work.  We need to adopt innovative approaches to keep up the momentum and address new challenges.  

I take this opportunity to congratulate Indiaclen and Madras University for documenting Tamil Nadu's experience. The document is well designed and captures the critical elements of HIV prevention and care and support activities in Tamil Nadu. This document will certainly help in showcasing to the world that our collective efforts in Tamil Nadu have resulted in success.  The US Government reaffirms its commitment to support the Government of India and the Government of Tamil Nadu and to partner with them in their continuing program to provide HIV/AIDS prevention, treatment, care and support in the state.

Thank You.