In a move that has sparked a debate over violation of HIV patients’ rights, the State Health Department is working on integrating the Karnataka AIDS Prevention Society (KSAPS) with the National Health Mission (NHM).
While patients say this will put HIV services at risk and further intensify stigma, officials say integration will further improve services and make it available in all general hospitals.
According to the proposal, a “rationalisation plan” has been chalked out to address staffing shortages and operational inefficiencies under the National AIDS Control Programme-V (2021-26).
The move aims to streamline resources, improve service delivery, and ensure optimal utilisation of sanctioned posts across various divisions.
Re-designation
The Health Department has identified several posts for re-designation and abolition to better align with programme needs. This includes re-designation of Joint Director (Basic Services) as Joint Director (AIDS Prevention). The post of Assistant Director (Prevention of Parent-to-Child Transmission- PPTCT) will be expanded to include Integrated Counselling and Testing Centre (ICTC) responsibilities. All 450 sanctioned counsellor posts and 455 sanctioned lab technician posts at ICTC centres will be retained, ensuring continuity in HIV testing and counselling services.
Posts such as Deputy Director (ICTC) and Divisional Assistant in certain divisions are proposed for abolition to reduce redundancy. The rationalisation plan emphasises retaining essential positions to ensure uninterrupted service delivery. Besides, posts of Senior Medical Officers (19 posts) and Medical Officers (43 posts) will also be retained to strengthen Anti-Retroviral Therapy (ART) and Link ART centres.
Serious concerns
However, the move has triggered serious concerns among patients, healthcare workers, public health experts, and civil society organisations.
“This integration poses a severe threat to Karnataka’s celebrated HIV control programme,” said David B., a HIV rights activist. “It disregards established national guidelines and WHO protocols,” he said, arguing that it “violates patients’ fundamental rights to health.”
Since its establishment in 1997, KSAPS has been a specialised, vertical programme under the National AIDS Control Organisation (NACO), delivering targeted, community-sensitive interventions in HIV prevention, testing, treatment, counselling, and awareness generation.
Karnataka, which ranks ninth in India in terms of HIV burden, has over 2.03 lakh people living with HIV (PLHIV) currently under care. With an HIV prevalence rate of 0.42% – twice the national average – any disruption to KSAPS services could have far-reaching public health consequences, he said.
Fayaz Ahmed, former president of KSAPS Employees’ Association, argued that HIV is not just a medical condition, but a complex behavioural and social challenge that requires specialised, stigma-free services including pre- and post-test counseling, mental health support, and long-term patient follow-up.
Overburdened system
“The integration of the trained workforce from KSAPS into the already overburdened general health system under NHM is short-sighted and harmful. The system we have built over decades ensures early diagnosis, counselling, adherence monitoring, and community outreach. Removing this structure means we risk reversing all our progress as patients are bound to discontinue treatment in general hospitals fearing stigma,” he argued.
Fears allayed
Allaying fears of patients, Harsh Gupta, Principal Secretary (Health and Family Welfare), told The Hindu that the proposed changes are aimed at optimising resources. “The idea is to reduce operational costs by abolishing redundant posts while retaining critical roles. This will not just improve efficiency but also streamline service delivery. The re-designation of roles is to align with programme objectives and focus will be on filling high-priority vacancies to address service gaps,” he said.
He said under the new system they would start with optimising the services of lab technicians. “Why can lab technicians in general and district hospitals not do HIV testing? This way we can ensure services are available closer to home for the patients. Going ahead, we can also use the doctors in these hospitals to treat HIV patients, maintaining confidentiality,” he said.
Mr. Gupta said that the rationalisation will be done in concurrence with NACO and discussions were already on. “If required, we will take up a pilot project before expanding it fully. We will also have a dialogue with patients and the HIV community to address their concerns,” he added.
Published – August 30, 2025 07:34 pm IST
