Which one is Getting to Zero? HIV or it's control programme

Seram Neken *

29th International AIDS Candlelight Memorial day by MNP+ at MDU hall, Imphal :: May 20 2012
Pix - Bunti Phurailatpam

With the opening of trans-national highways and onset of railway lines, the threat of HIV will take a new course in Manipur. Does the State AIDS policy incorporate enough provisions to meet these challenges? Are we well prepared?

HIV takes a few years to manifest itself in the infected human body. Infection occurring today will be reflected after five to ten years. The Manipur State AIDS Control Society has claimed successful control of the epidemic in Manipur with the decreasing rate of infection among the pre-natal mothers. However, the statistics that is reflected today is the outcome of the efforts made five and more years ago. The effectiveness of the current programmes has to be gauged after five to ten years. So, please do not be complacent on the available statistics. Rather, dwell on the quality of the programmes going on at present.

December one comes and goes. Stereotyped speeches of VIPs and VVIPs, routine gathering of health officials and NGOs, reading out existing statistics, feeling complacency on existing programmes etc. mark the annual observance of World AIDS Day this year. Every speaker who says 'AIDS is alarming in Manipur' also says that 'AIDS has been successfully controlled in the state with the rate of infection coming down'.

Apparently acknowledging the need for public support in combating the disease, every speaker appeals to all to join the movement against AIDS. However, it was unfortunate that mass involvement was not seen in the observance. No rally, no public participation, no effective media campaign, no radio jingle, no TV spot, no effective poster, no appealing hoarding, no valuable pamphlet, no students' contest and so on and so forth. It is wonderful how we can mould a mass movement against HIV in Manipur.

In spite of hectic efforts worldwide, there is no effective vaccine against HIV and no standard medicine to cure AIDS. Complete awareness of the ways of transmission, adoption of a positive behaviour, development of health seeking behaviour, pre-marital HIV testing with informed consent, pre-natal HIV testing of pregnant mothers etc. are important vaccines against HIV.

Following a positive lifestyle, availing regular care and support services including adherence to Ante-retroviral Treatment, constant health check-ups etc. are the available medicines for maintaining long and quality life of HIV infected individuals. We need to categorically examine what is being done in Manipur at present in regard to HIV prevention and AIDS management aspects.

How many young couples are married in a single day in Manipur?
How many teenagers attain adolescence in a single day?
Are they getting HIV prevention messages? If so, through what media they are getting HIV prevention messages?
Will only a sporadic and occasional broadcast, publication or telecast of preventive messages be effective to these young people?
Are they going to obey the protective measures?
How frequent do the messages reach the ears and eyes of sexually active youths?
Is there enough and effective media materials to reach the nook and corner of the state?

All prevention efforts will become futile, unless they appeal to young minds. It is not a mere job to educate and bring positive behaviour among the huge number of youths of the state. Effective messages need to reach them on a constant basis through all available means. Are these things being done by the State AIDS Control Society in Manipur to prevent new infections?

All programmes right from harm reduction in drug use to administering of ART, will require effective communication between the service provider (government) and the public (clients and general people). Does the Manipur AIDS Control Society assess the effectiveness of its intervention programmes with field study, or does it rely on statistics submitted from various institutions ?

Of course, statistics has become better off nowadays as compared to the situation a decade ago. However, it should be noted that the outcome of present efforts will be known after some years. Present data do not reflect the fruits of the present programmes. They only say what was done years ago.

During AIDS day observances, one surely hears dignitaries saying 'AIDS is alarming in Manipur' and again 'we are able to control it in the state'. What actually is the situation of the epidemic ? Stereotyped speeches of the dignitaries need a change. When leaders speak out from their heart, the observance will be more meaningful.
The public also wants certain innovative actions to be taken up in state to control the disease. Locally specific, culturally adaptable programmes will appeal to the minds of our people. Copy-cat designs in the name of national guidelines like the holding of rock-music contest for HIV prevention in Manipur will bring negligible results.

It is joked at certain circles that the AIDS programme managers may mistakenly propose to organize HIV Beauty Contest, AIDS Fashion Shows in the state. May it not happen to the state.

Manipur is proud of being the first state to have a State AIDS Policy adopted in 1996. Being the highest HIV prevalent state in the country, Manipur was also most advanced state in managing the epidemic. After more than a decade of stiff efforts, now the rate of prevalence has been brought down. However, still new infections among newly teenaged people apparently continue unaware in the nook and corner.

Burgeoning flesh trade, insufficient preventive communication and lethargic implementation of control programme will manifest increase of infections after a few years. It is amazing that the revision of the State AIDS policy takes more than three years. Yet the state Chief Minister says it will be finalized soon. Has AIDS lost its urgency in Manipur ?

World AIDS Day is an observance to generate AIDS awareness to the people. Its meaning lies when people in the nook and corner participate it in any manner. Money spent in arranging huge functions at state headquarters may be scattered to hill remote areas to sensitise people.

It is time to dwell on quality programmes of prevention and intervention. We need to reach out to people who are actually unaware of the disease. Otherwise, the prevention and control programmes will be getting to Zero, ahead of HIV itself.