By Seram Neken
When the first HIV positive case in Manipur was detected in the last week of February 1990, the report ignited massive response from various sections of the population including the Manipur Police, NGOs, Meira Paibees, Civil Society bodies and underground elements leading to adoption of compulsory measures which in turn caused rapid increase in the prevalence of HIV among Injecting Drug Users (IDUs).
The HIV prevalence among IDUs increased from 1% in 1990 to 50% in just six months and to 80.7% in 1997, which was the highest record in the world. Manipur was at one time known as AIDS Capital of India. The leadership of the State AIDS Committee in Manipur, at that time, took a bold decision to introduce a State Policy to combat the HIV/AIDS epidemic on scientific lines. Hence, Manipur State AIDS Policy was passed on 3rd October 1996 as the first and the only state policy in India. Following the footsteps of Manipur, the National AIDS Control Organisation (NACO) also introduced the National AIDS Policy later in 2002. The leadership of the Manipur State AIDS Control Society (MACS) also introduced the Rapid Intervention and Care Project (RIAC) as a harm reduction programme among Targeted Population for the first time in India with support and funding from NACO. This project has so far been duplicated in many states in India.
In fact, Manipur was the pioneer in introducing many innovative AIDS control programmes in India. As a result, the HIV prevalence rate among Injecting Drug Users dropped from 80.7% in 1997 to below 15% in 2010. Today, more than 40 NGOs are working with dedication and commitment in the field of Targeted Intervention for IDUs. The latest sentinel surveillance report indicated that the HIV prevalence among pregnant women, Female Sex Workers, Men having Sex with Men, and Migrant Workers have shown a significant decline during the last 20 years. The NGOs must be given credit for their commitment, dedication and good achievement.
Still Manipur is one of the worst affected states in India requiring action on a war footing. We need to achieve the target of Getting to Zero – zero new infection, zero deaths, zero discrimination by 2015. This is a great challenge requiring coordinated and concerted action from all agencies and departments. This is not the time for lethargy, delay or negligence. However, the present working of the MACS is far from achieving the desired goals. Although the present Project Director of MACS is not responsible for these lapses, he can easily correct it. He needs to assert his authorities without hesitation in the best interest of the AIDS Control Programme in the state.
Unfortunately, the state government keeps on changing the Project Director of MACS very frequently and also he is given additional portfolios like Home, Finance etc. Since Home and Finance are very important departments, the Project Director has little time to think about HIV/AIDS. It is as if, he is acting as a part-time head of MACS which actually affects the programme adversely. Moreover, the MACS was established as an autonomous body with its own rules and regulations in 1998.
The present finance section of MACS is headed by a young and inexperienced officer of Manipur Finance Service who apparently assumes MACS as a government department and applies all the rules and regulations of the government leading to failure, delay and inefficiency of the programme. While being successful in delaying and objecting to many important proposals, the finance section of MACS cannot appreciate the difference between autonomous and government institutions. The finance section of MACS requires a senior officer who knows both the functioning of autonomous bodies and the urgency of the AIDS Control Programme.
The Project Director needs to ponder over the fact that ownership of AIDS Control Programme belongs to the Project Director, not the Finance Officer. This reminded the people of the fate of MSRTC, Spinning Mill, Cement factory, Sugar factory etc. which remained defunct due to mismanagement of deputed officials. The responsible heads of these institutions were deputed from the state government and they had destroyed these institutions leading to loss of crores of rupees, loss of manpower, and loss of prestige of the government. People from various circles ask whether the finance management in MACS is trying to convert MACS into an institution like MSRTC, Spinning Mill, Cement factory, or Sugar factory.
The working of MACS needs urgent revamping and overall improvement. Presently, all the files are put up to the Health Minister for a decision curtailing the authorities of the Project Director and the Principal Secretary, causing unnecessarily delay in the procedure. The undue process may also lead to corruption and nepotism. The decision of the Executive Committee and the Governing Body should be taken as final. Acknowledging that HIV spreads very fast through needle sharing and sex, we must also work faster than HIV to control the epidemic.
About six months back, nine NGOs were terminated on the basis of findings of the Evaluation. Subsequently, over 6000 clients are left without any intervention and care. They must be sharing needles and syringes and must be having sex without condoms. In other words, they must be spreading HIV to their injecting partners, sex partners and common people. Even though the MACS already invited other NGOs to replace the nine terminated NGOs, the process has been trapped in red tapism. The MACS may immediately finalise the NGOs at the level of Project Director and the Principal Secretary and put up to the Executive Committee under chairmanship of the Principal Secretary for final approval. The special attention of the Project Director/MACS and the Principal Secretary (Health & FW) is invited to examine these issues and take remedial measures for revamping MACS without further delay. These actions are required if we are to achieve the target of getting to zero by 2015.
(The writer is an Imphal-based Journalist. He is available at nekenseram@gmail.com)