FHI also works across Asia and Africa to mitigate the impact of HIV/AIDS globally. HIV/AIDS is a global problem and a concern addressed by many national and international organizations committed to mitigate the effects of the epidemic. FHI is one of such organizations that have worked in Nepal on HIV/AIDS issues for more than a decade. FHI works under the directive of National Center for AIDS and STD Control (NCASC) and according to the HIV/AIDS National Action Plan (NAP). FHI also works across Asia and Africa to mitigate the impact of HIV/AIDS globally.

It has been estimated that 69,000 Nepalese are living with HIV. The HIV infection is concentrated among sex workers and their clients, injecting drug users, men who has sex with men, migrant workers and their wives and children.

Family Health International (FHI) Nepal implements the United States Agency for International Development (USAID) Nepal supported ASHA (Advancing Surveillance, Policies, Prevention, Care, and Support to Fight HIV/AIDS in Nepal) project. FHI works in partnership with Futures Group International and Association of Medical Doctors of Asia (AMDA) on the ASHA project. FHI Nepal also implements the DFID Regional Directorate funded Reaching Across Borders (RAB) project in coordination with FHI India in FarWest Nepal and in Mumbai and Delhi in India targeting Nepali migrants and their spouses from the FarWestern region.

FHI through the ASHA project as well as through previous USAID funded IMPACT, AIDSCAP projects has focused on strengthening the national capacity through local capacity strengthening, especially at the district level, to respond to the HIV epidemic. Currently FHI works in partnership with more than 50 local partners across Nepal who in turn collaborate and coordinate with local partners on the ground to mitigate the HIV/AIDS epidemic. The ASHA project activities include prevention programs for Most-at-risk groups, treatment, care and support programs for people living with HIV/AIDS, as well as advocacy and policy, research and surveillance.

FHI has five regional field offices located in Itahari (Eastern region), Hetauda (Central Terai), Pokhara (Western region), Nepalgunj (Mid and FarWest region) and Dhangadi (FarWest region).

The ASHA project covers 36 districts nationwide. FHI through the ASHA project runs 28 sites providing STI diagnosis and treatment, 33 sites providing counseling and testing, and 33 sites providing HIV care and support through its local implementing partners across Nepal. 15 districts have also been distinguished for DACC strengthening.

The combined achievement of the ASHA and the RAB project till FY 08 are such that

• More than 217,000 individuals have been reached through community outreach that promotes HIV prevention through behavior change.
• Nearly 42,000 of most at risk population (MARPs) have been provided STI examination. Nearly 40,000 individuals have received counseling, HIV testing and results through voluntary counseling and testing (VCT) services.
• Nearly 6,400 people living with HIV/AIDS (PLHA) have been reached with palliative care and support services which include clinical services for regular checkups as well as home based care.
• More than 570 PLHA are receiving ART.

Positive prevention programs and the Universal Access for Children Affected by AIDS in Nepal (UCAAN) initiative are new initiatives of FHI. People living with HIV/AIDS (PLHA) run NGOs conduct positive prevention programs for PLHA. The UCAAN initiative is a partnership started end of 2007 by FHI, UNICEF, USAID Nepal for USG and NAP+N. The open UCAAN partnership has grown to include more than 20 partner organization by the end of 2008.

All in all, through partnerships, collaboration and technical leadership FHI Nepal with USAID support is contributing to mitigate the impact of HIV/AIDS in Nepal.n