HIV epidemic is unfolding at a rapid pace in South-East Asia. About 63% of estimated HIV infections in the region are from India. First cluster of HIV infection was reported from Chennai in 1986. India already has the second highest load of HIV infections of all countries globally. It is estimated that there were 3.86 million HIV infected persons in India by December 2000. HIV epidemic has already become generalized in six Indian states that include 45 districts with high HIV prevalence rates in various sub-populations. Being a country in health and demographic transition, the propensity of HIV epidemic to cause secondary epidemics is likely to increase disease burden of communicable diseases significantly. The disease burden due to HIV / AIDS and AIDS mortality is likely to peak around 2010. A comprehensive National AIDS Control Programme (NACP) was initiated in 1992. To reverse the trend of HIV epidemic and to achieve the goal of zero level growth of HIV infection by 2007 as envisaged in the draft of National Health Policy 200 1, strengthening preventive and care-related interventions is essential. However, on the research front limited data on HIV and AIDS has been generated by a few centers in the country. These research efforts are isolated. Coordinated efforts of these centers will be very important in maximal utilization of well-developed research infrastructure and expertise. Research to develop and strengthen effective intervention strategies and cost-effective treatment options for those already infected is necessary. We propose to develop a network of institutions working in the field of HIV/AIDS with the objective of undertaking a multi-centric multi-project research activity in India. Comprehensive International Programme for Research in AIDS (CIPRA) will provide an excellent opportunity to establish such a network. The Indian Council of Medical Research will be the nucleus of this network that shall also include reputed institutions outside ICMR network and community-based organisations. The network will establish a common research agenda. Its activities will be guided by a National Advisory Committee (NAC). Working groups comprising of experienced investigators from the participating institutes will be established for each of the identified areas. The Working groups will meet at least twice during the first six months of the project period. Communication links will be established between the members of the committees through Internet connectivity. The working groups will identify the lacunae in the knowledge and set the precise research goals and design appropriate studies, identify the institutions within the network for carrying out the research agenda, prepare the budget for the programme and identify specific training requirements. The research applications shall be reviewed by the NAC and National Ethics Committee using ICMR ethical guidelines that are accepted by NIH. Institutions will be identified for establishing core facilities. The needs for strengthening the core facilities in terms of equipment and training will be identified. A comprehensive application based on the research agendas developed by each of the working groups will be developed for a multi-project, multi-centric research program that would complement the ongoing Indo-US studies and assist in formulating policies in the field of HIV/AIDS in India.
