The problem of drug abuse has added to the difficulties in tackling HIV/AIDS, which has become a health emergency in the Northeastern State.
IN THE 15 years since the first HIV-positive case was reported in Manipur in February 1990, AIDS has became a serious health emergency.
By June this year, 20,297 Human Immuno-Deficiency Virus-positive cases, including 3,917 women, and 3,466 Acquired Immune Deficiency Syndrome cases (492 deaths), were reported out of 1,26,036 blood samples screened. This works out to a sero-positivity rate of 161.04 per 1,000 blood samples screened. Officials of the Manipur State AIDS Control Society (MSACS), however, put the figure of HIV-positive cases at more than 40,000, saying a large number of cases are unreported.
The HIV sero-prevalence among injecting drug users (IDUs) in Manipur, one of the highest in the world, increased from 0 to 50 per cent in just one year - 1990-91. The sero-prevalence rate among pregnant women is also increasing alarmingly.
Close to Golden Triangle
In the late 1970s and early 1980s, Manipur became an alternative route for international drug trafficking because of its proximity to Myanmar, Laos, and Thailand, the infamous "Golden Triangle."
By the early 1980s, it became a "user State." Pure heroin, which is injectable and is locally known as "No. 4," was easily available; "shooting galleries" for IDUs mushroomed in districts such as Churachandpur. In the districts bordering Myanmar, a single dose can be had for just Rs.20 against Rs.100 in Imphal.
The dreaded disease soon spread among the IDUs. "We used to share the syringes while taking the doses little realising that the dreaded disease has already spread from one of the affected members of the group," say Ng Ratan Singh and Kh Gyaneshor, secretary and treasurer of the Manipur Network of Positive People (MNP+).
Fighting against discrimination
The MNP+ was formed on September 7, 1997, by five persons as a self-support group to overcome the discrimination PLWHAs (People living with HIV/AIDS) faced in society. The group has been encouraging its members to share their personal experiences, and has been lobbying for legislation to protect the basic human rights and needs of all PLWHAs, including the right to employment, education, medical care, insurance. It has also been conducting meetings, workshops and conferences across the State, providing counselling, and encouraging the formation of self-help groups.
The HIV/AIDS epidemic in Manipur is now no longer confined to the IDUs. It has spread to their partners and their children. Manipur is the first State in the country to adopt a harm reduction programme. The MSACS-formulated strategy calls for creating a helpful, supportive, and enabling social environment in the community so that people can come forward for voluntary HIV testing. It also encourages and supports voluntary pre-marital testing with informed consent and appropriate counselling.
A major gap area in the various AIDS intervention programmes being implemented in the State is that the National AIDS Control Organisation (NACO) guidelines do not allow the MSACS to undertake any direct intervention programme for AIDS widows and orphans such as building orphanages or shelter homes.
Duplication of programmes
There has been a duplication of the intervention programmes/harm reduction strategies in the State by various agencies.
However, while the AIDS widows and orphans continue to be deprived of the benefits of the programmes being implemented either by the MSACS or by NGOs with funding from donors such as Microsoft chief Bill Gates or the former United States President, Bill Clinton. MSACS deputy director A. Gajendra says they have impressed upon the NACO that other agencies should not duplicate the MSACS’ initiatives. Manipur is one of the country’s six States with high AIDS prevalence. The other north-eastern State in the list is Nagaland. The Clinton Foundation, according to Dr. Gajendra and MNP+ activists, has expressed its desire to provide some ARV drugs.
For Manipur, however, the primary problem of preventing drug inflows from the infamous Golden Triangle remains a major challenge.