Introduction :

  HIV/AIDS Situation:

Since the first case of AIDS was detected in Nepal in 1988, the epidemic has progressed at a rather alarming rate. Nepal has already progressed from a 'low prevalence' country to one with a so-called concentrated epidemic among certain sub-groups of the population. The predominant mode of transmission is sexual, presumably heterosexual and injecting drug use. As of August 2006, NCASC reported a total of 7373 cases of HIV infection in Nepal of which 1115 were reported to have progressed to full-blown AIDS and 340 AIDS related deaths had occurred . However, it is feared that these reported figures do not portray the true situation and UNAIDS/WHO estimates point to a much higher figure of 70,000 infections by the end of the year 2005. This very large difference between reported and estimated figures may be attributed mainly to the lack of Voluntary Counseling and Testing services [VCT], stigma and discrimination associated with HIV & AIDS, fear of being exposed, denial and the poor surveillance and reporting system in Nepal.

Compared to other countries in Asia and the rest of the world, available epidemiological data suggests that Nepal can be considered a low prevalence country. However, this low prevalence in the general population masks increasing prevalence in several groups and new epidemiological data reveals that the epidemic is increasing at an alarming rate in certain sub-groups. Studies reveal that there is widespread high-risk behavior among CSWs and their clients, IDU, youth and migrant populations. An explosive increase in HIV prevalence among various high risk groups has occurred. 2-3 percent commercial sex workers along the east west highway, Katmandu and Pokhara valley are infected by HIV. Similarly, a study reveled that 3.9 percent of males having sex with male (MSM) are infected with HIV (New ERA, 2003/4). Migration plays an important role in the HIV epidemic in Nepal. An estimated 1.5–2 million Nepali nationals are working overseas, including 1 million in India. HIV prevalence among migrants returning from places such as Mumbai (India) ranges between 7.7-10 percent (New ERA and JICA, 2004, HIV/STI risk behaviors among migrants in Doti and Achham district/ NCASC, FHI). HIV/STI prevalence and risk factors among male migrants and non-migrants in Kailali District) Among the estimated 30,000 IDU in the country, 40 per cent are HIV positive, but there is wide regional variation with 51 percent in Kathmandu and 22 percent in Pokhara (NCASC, National HIV/AIDS strategy 2002-2006/NCASC, FHI/behavioral and sero-prevalence study among the injecting drug users in Pokhara valley: (Summary Report March 2003.)
 

  National Trends:

• The epidemic is shifting from high risk population groups to low risk population groups through mobile population
• The concentration of the disease is shifting to young people ( especially migrant population)
• There is lack of access to ARV ,
• Prevailing stigma and discriminations are impeding factors for increasing access to available services
• Inclusive advocacy approach at all levels (community to policy) is critically important to be able to appreciate the gravity of the problem
• Nepal is experiencing increased rate of HIV & AIDS in the 15 – 39 age groups.

The current HIV & AIDS situation shows that efforts made in the recent past to address the HIV problem are not adequate in Nepal. Focused interventions to some extent were able to combat HIV spread among high risk groups, however it failed to safeguard the bridge populations especially migrants, IDPs, transport workers and clients of CSWs.

Access to generic drugs among the HIV positive people is increasing. There is rise in consciousness towards HIV positive people and advocacy for rights based programs for them. This has enabled a well functional network such as NANGAN to formulate a comprehensive strategic plan to reverse the rate of HIV & AIDS through network members.
 

 NANGAN’s Vision:

A Society without AIDS

NANGAN’s Mission:

NANGAN is committed to support its members in preventing HIV, through treatment and care for infected/affected people by HIV & AIDS with values of solidarity, empathy and respect for rights of all through providing an effective communications and sharing of information, policy influence, capacity building of member organizations, advocacy, and coordination.

NANGAN’s Goals:

Contribute effectively to the reduction of current HIV & AIDs prevalence rate in line with Millennium Development Goal (MDG) for Nepal
 

  NANGAN’s Objectives:

The objectives of NANGAN are to:

1.1. Advocate for effective policy at national/ local level in order to insure the rights of the PLWHA and other vulnerable groups and to implement HIV/AIDS programs in the country by the end of 2010;

1.2. Enhance the capacity of NANGAN and its member organizations through training and establishing decentralized & effective network units by the end of 2010;

1.3. Establish a knowledge resources facility in the HIV/AIDS sector in smoothing and strengthen network information sharing capacity among member organizations and other stakeholders by the end of 2010;

1.4. Coordinate, collaborate and cooperate with GOs/I/NGOs and civil society working for HIV/AIDS prevention, control, care and support.

NANGAN’s Strategies:

The NANGAN has six prolong strategies.

1.5. Conducting effective policy and public advocacy related to HIV/AIDS at various levels by mobilizing the member organizations in solidarity with international partners through its capacity as a national network.

1.6. Lobbying for national level policy formation on HIV/AIDS by creating access to opportunity in resources for member organization through the use of the network’s recognition and image.

1.7. Building capacity of NANGAN and its member organizations through trainings, exposure visits, technical support and experience sharing at the central as well as the district level through utilizing the experience of members and resources of partner organizations by creating a sensitive critical mass base at grassroots level, which addresses issues relating HIV/AIDS.

1.8. Establishing a national resource facility for systematic data collection, policy analysis, advocacy work and capacity building of its member organizations through the utilization of NANGAN’s strengthened network and with the support of its stakeholders.

1.9. Building and strengthening the district, regional and national level Networks through a process of democratic election/ nomination by the registered members of NANGAN and providing membership to eminent organizations.

1.10. Coordinating with stakeholders through its national and decentralized units in order to access resources for effective implementation of initiatives against HIV & AIDS.