AIDS problem turning serious in NE

[Guest guest]

AIDS problem turning serious in NE

By Surajit Khaund

GUWAHATI, Sept 19 - AIDS problem in North East has taken a serious turn due to

increase, in number of injecting drug users. To counter the menace a

comprehensive effort is urgently required.

This was observed by Dr Denis Broun, country coordinator of UNAIDS. Talking to

The Assam Tribune here, Dr Broun, said that in view of growing cases of

AIDS/HIV, the UNAIDS has decided to take a slew of measures to overcome the

problem. " Initially we are planning to conduct an indepth study to find out the

root cause of the problem.

Though injecting drug is the major reason for the HIV, we will have

to study the other pros and cons in this regard, " Dr Broun said while

disclosing his future plans in the North East. Dr Broun who was also the chief

of health section of UNICEF, informed that UNAIDS would provide medicines and

training to the workers and NGOs working in the field of AIDS.

" Our experts will be visiting the region frequently to assist the workers to

speed up operation, " he said, adding that though the problem has been contained

in several States in India, this region is yet to make any significant progress.

Citing reasons for poor progress, Dr Broun pointed out that availability of

injecting drugs is a major problem in the North East that has aggravated the

problem to a large extent. " As per the report, Manipur has been worst affected

as far as HIV is concerned over the years.

Injecting drug users in Manipur have been increasing causing a serious

problem for the youths. The need of the hour is that to stop flow of

injecting drugs, " Dr Broun added.

Broun arrived here yesterday to gear up activities in association with the local

organisations fighting against AIDS over the years.

On a specific question on spurt in cases of HIV in the region, he observed that

the unemployment problem has forced the youths to take heroin and other

injecting drugs. " Due to sharing of needles while taking drugs, the HIV cases

are also increasing day by day in the region, " he said.

The three States of North East-Manipur, Nagaland and Mizoram, bordering Myanmar

have been witnessing severe drug trafficking problem over the years.

A study shows that there are about two lakh drug addicts in the region. Porous

border and lack of security personnel have made the problem more acute.

http://www.assamtribune.com/scripts/details.asp?id=sep2007/at06

_____

ROY LAIFUNGBAM

CORE Centre for Organisation Research & Education

Loisanglen: Post Box No. 99

Gate No.2, Palace Compound

Imphal 795001, Manipur India

Tel/Fax: +91 (385) 2228169

Email: coreloisanglen@...

[Guest guest]

Dear Forum,

AIDS problem turning serious in NE

Re: /message/7853

HIV prevalence among the female sex workers in several states of North East

India like Nagaland, Mizoram is showing increasing trend for last several years

as per the source of sentinel surveillance data. The figure of Manipur, though

showing decreasing trend is not very promising.

Rest of the states, due to some reason or other do not have prevalence data for

the sex workers except Assam.

Interestingly HIV prevalence among STI cases showing increasing trend in

Nagaland, Mizoram without much obvious changes in Manipur and Assam.

I did the analysis of the sentinel surveillance data from 2003 - 05 of the NE

states last year while working with NACO.

I like to know the view of the learned members of the forum. Is the epidemic

gradually shifting from the IDUs to the sex industries in the NE states?

In Manipur and Nagaland the epidemic is already generalized and if it starts

hitting the sex industries as well the situation may take a very serious turn in

near future.

There are a number of possibilities to be taken into consideration like,

1) May be, not enough emphasis is given on safe sex intervention like condom and

STI management, specially within the sex workers and their clients and partners

because the main focus is so strongly imposed on the HR activities for the IDUs

2) Strong linkages between sex industries and drug users may exist where an

addict may join the profession for easy money for buying drugs or sex workers

share drugs with their clients/partners where needle/syringe sharing may take

place consistently. This is also a common finding in a number of SE Asian

countries, Australia, Canada, South Africa and Russia.

3) Left out female partner of the expired IDUs may have no option left other

than joining sex profession when she has been already infected. also a finding

from the other countries.

4) Sustained political instability, unemployment, poverty in the NE states may

easily add adequate fuel to this alarming situation.

It will be very nice to know the real picture of the NE states from the members

of the forum regarding this matter.

Best Regards,

Sugata

Sugata Ganguly

e-mail: <sugataids@...>

[Guest guest]

Dear Forum,

Response to - AIDS problem turning serious in NE

Re: /message/7853

Being from the drug users’ community, we are working in the issues for more than

a decade in the state of Manipur and NE region and as such we are experiencing

that more and more PLHAs are dying and also drug user population among the youth

has been increasing over the years.

As the existing intervention program focuses on the down line streaming

approach, there is no such program which can addresses drug use or initiative

among the youth including female IDUs.

Existing TI among IDUs focuses mainly among the already infected by the drug

use. Hence, there is no such a component or specific activity to target among

youth, female and spouse of IDUs. Even in the NACP III there isn’t any specific

component to target among youth and spouses of IDUs. Hence, it is obvious that

drug use and HIV/AIDS will increase automatically.

Having a look as per the Manipur SACS data, there are 25,000 PLHAs in 2007 out

which 5000 have already died due to AIDS related cases. But this death figure is

still yet to be updated and has not been increased for the last six to eight

years taking into account the official figures but in reality, PLHAs are dying

unofficially from our own working experience.

Taking an examples in my locality during my drugging days, there are 26 drug

users’ brothers and friends but now there were there only two of us left and

still alive.

People believe that when NACO – National AIDS Control Organization 3 by 5

initiatives started from first April 2004, somehow HIV will become a manageable

disease with high hopes in the state.

On the other hand Injecting drug users’ living with HIV/AIDS (ILWHA) are dying

not with HIV but with HCV (hepatitis C virus) as HCV make much faster inroad in

damaging the liver and also the toxicity of ARV medication in the liver among

the ILWHAs in the state as well as in other Northeast state specially Nagaland

and Mizoram.

On the other hand drug user community in Manipur are aware and had information

with regards to HCV whereas IDUs in Nagaland and Mizoram have very little

knowledge.

Now I would say ‘the third epidemic’ has started which has not been able to

address at all because of high cost of interferon treatment for HCV. Beside,

there is no policy or program in the state AIDS policy at present.

During the year 2001, ICMR and local NGOs conducted an assessment of HCV

(Hepatitis C virus) prevalence among the ILWHAs among 250 samples and it shows

that 98% in Churachandpur and 92% in Imphal district of Manipur are coinfected.

Hence, HIV co-infection with HCV is one of the emergent health issues in the

state of Manipur.

As we are all aware, Manipur is one of the six highest HIV prevalent states in

India among IDUs with 90% in the year 1991. Manipur SACS claim that HIV

prevalence has come down to 24% in 2007 but being working in the issues ‘I am

totally confused’ on this data as there are still various issues where Harm

Reduction program could not be provided/implemented in an effective way and

there are areas left untouched by RIAC!.

Not to speak of critical gaps in the implementation. Beside, Manipur is a state

with a diversity of culture and linguistic having a large number of distinct

ethnic communities.

This often leads to considerable tension among the various ethnic communities.

Ethnic conflict, corruption and a loss of faith in the political process have

contributed to the formation of armed insurgent groups, and drug use and

HIV/AIDS impacts greatly on social and economic stability in the state.

And the authority did not have the time to take the epidemic seriously till

date. And this is of grave concern for us if not for those who matters.

Hence, drug user among youth including young female and Injecting drug user

living with HIV/AIDS (ILWHA) co infection with HCV is a complex issue in the

state; more than 99% of people are unable to get access to treatment due to high

cost. Due to the PLHAs co-infection with HCV, the life span among the ILWHAs is

shortening as compared with other PLWHA.

At present, access to treatment is still very complicated and a big challenge

among ILWHAs due to poor infrastructure and inexperienced medical personnel of

the Govt. establishments. Moreover, the risks are alarming and more acute from

the other vulnerable groups, and it also contributes future HCV prevalence.

There is an immediate need for comprehensive response to address from the

further spread and dying of ILWHAs co-infections with HCV. There is urgent need

for scientific, clinical study or research which is greatly required in order to

response and takes up effective intervention and prevention program.

And also there is immediate need for treatment literacy and political dialogue,

awareness and commitment in the issues.

The need of the hour is to review and re-look the existing IDUs program

especially in the Northeast state of India so as to reduce the HIV prevalence

among the IDUs!!??

Regards,

Bangkim Chingsubam

Mr. Ch. Bangkim

SASO-Social Awareness Service Organisation

Uripok Sinam Leikai Opp. Common School

Imphal - 795001 Manipur (INDIA)

Phone:91-385-2411408, Fax:91-385-2411409

Mobile:91-0 9436036213

bankimimph@...

cbangkim@...