An HIV scare looms large over Mumbai as regular supply of condoms, syringes and medicines to tackle the deadly virus has nearly dried up in its most vulnerable pockets. Twenty-one NGOs (non-governmental organizations) and 13 community-based organizations (CBOs) that handle a total of 52 intervention projects for the city's population at highest risk of contacting and spreading HIV have not received central government funds since April.

This blow comes at a time when already close to 60,000 of the 4.20 lakh individuals in the state afflicted with HIV are living in the city. Although its prevalence in the general population has been on a decline, the graph has only been rising for the high-risk groups.

The crunch in funds has directly affected efforts made by agencies to protect an estimated 2.34 lakh high-risk individuals. They include female sex workers (FSW), transgender individuals, men having sex with men (MSM), intravenous drug users (IDU), truckers and migrants. Currently, HIV prevalence among FSW is as high as 27%, 18% in IDUs, 12% in MSM and 30% in the transgender population.

Following the fund crisis, most NGOs and CBOs have been forced to downsize their workforce and a few have even completely stalled their work. Funds allocated to each project vary from Rs 9 lakh to 20 lakh, depending on its reach. Without the money, most organizations have been unable to pay their staffers, and have defaulted on the rents and electricity bills. The worst hit are some former sex workers-turned-outreach workers and -peer educators, who have had to go back to their old ways to support their families.

TOI came across one such outreach worker from Malwani who said she waited for two months for her salary of Rs 7,000 to arrive. "On the third month, I had no choice but to do the only work I knew," said the worker, who is associated with a CBO that caters to the transgender population. As an outreach worker, her job is to visit brothels to distribute condoms and inform new entrants about prevention.

A Ghatkopar-based NGO told TOI that they were struggling to even purchase stationery for daily use while a south Mumbai CBO that works with MSM said they had to take huge loans to meet ends. Eldred Tellis, director of Sankalp Rehabilitation Trust, said he had to borrow approximately Rs 7.5 lakh from his trust's buffer to sustain three IDU projects. "Though bigger NGOs can sustain for a while, smaller organizations are finding it extremely difficult to cope," he said.

Ashok Row Kavi, founder-chairperson of Humsafar Trust, also said three of his MSM projects were badly hit. "Without paying salaries, how can I expect my volunteers to be present at the site and distribute condoms everyday? This (fund crunch) has created a dent in the measures taken so far and an increase in HIV prevalence is likely," he said.

Dr Balkrishna Adsul, additional project director of Mumbai District Aids Control Society ( MDACS), said, "The delay was from NACO's end. But funds have arrived now and we have started disbursing it already." He also said the crunch at the Centre could be caused by the drying up of money from global agencies. Geneva-based Global Fund (GF) had announced stoppage of funds till 2014 for diseases, including HIV, in India.

Dr Neeraj Dhingra, deputy director general, NACO, said he would check how and why the crunch happened. "There is sufficient money to fund projects as long as NGOs are clear with their records," he said.

* Author: Sumitra Deb Roy
* News story courtesy TNN
* Image courtesy Reuters