An Open Letter to the NACO

By Rajesh Khongbantabam *

An Open Letter to the NACO, D.G.
for addressing the needs and requirement of drug
using populace in the state of Manipur

Respected madam,

At the very outset, I would like to stress on the need of the hour based on the experiences faced by the members of our network, MANDU comprising the beneficiaries of buprenorphine therapy.

I would like to apprise your good self that though our needs and requirements are numerous taking into consideration the fact that our network is the pioneer in this particular CBO, I would like to take this opportunity to highlight only the immediate requirements for favour of your kind perusal and necessary approval.

I would like to bring to your kind notice that the buprenorphine substitution programme that is currently undertaken under the aegis of Emmanuel hospital association (EHA) is a highly prolific programme that has had a resounding impact in containing various issues relating to harm reduction and drug treatment and a number of drug users have emerged from their closet for availing the benefits of the said programme.

At present, there are more than 500 drug users' availing the said programme in the state and the statistics of the same is ever-increasing owing to largely to the feasibility of the said programme.

However, I would like to impress upon your good self that there are still numerous gaps to be addressed in the practical implementation of the buprenorphine substitution programme at present leading to various difficulties and inconveniences among the beneficiaries of the same.

In this regard, strengthening the base of implementation of the policies and programmes of substitution therapy for achieving maximum results in the ultimate goal of achieving harm minimization and drug treatment is highly required at the present juncture for there are many more potential beneficiaries who are yet to avail the said programme and who have shied away from the same due to the gaps in the said programme.

Moreover, in the event of having no concrete policies and programmes regarding the implementation of the same by the present sponsors, the framing and incorporation of the same is highly imperative considering the ever-increasing needs and requirements towards fulfillment of the same. I would like to add in this regard that if the options of drug treatment are spread out on a more broader base than the already existing infrastructure, the consequences of the same would be more far-reaching and productive.

It is pertinent to remind your good self that for our community comprising of drug users' in our state, there are no alternatives available other than the substitution therapy programme for coming back to the mainstream of society in a legalized manner and from reverting back from the marginalized to the unmarginalised.

Therefore, in order to fill in the gaps as mentioned above for striving towards better implementation of the said programme, inclusion of the Substitution in the National AIDS Control Programme phase lll (NACP lll) is highly imperative and the need of the hour for reaching out to the needs and requirement of the ever-increasing drug using populace.

Some of the gaps that need to be addressed in the existing harm reduction services are, for instances, over-dose management, abscess management, O.I services, care and support, skills training for rehabilitation, job orientation and so on. I have a firm belief and confidence that in the event of the said BST programme under the aegis of NACP lll, the objective of maximizing the harm reduction and drug treatment programme would be realized to a great extent and eventually contain the growing menace.

Taking into consideration the ever-changing needs and requirements of the drug using populace, a more meaningful and greater involvement of drug users' in policy making programmes and representation of drug users' in key committees are rendered highly necessary in order to enable the implementing agencies in providing qualitative service and reach out to each and every potential member.

In view of the foregoing premises, I shall, therefore, be very indebted if your good self would kindly empathize with the plight of drug users' of the state and address our grievances in the interest of equity, good conscience and natural justices.

Yours sincerely
Rajesh Khongbantabam
(An advocate of substitution treatment)