NACO's data on AIDS cases in NE challenged

NEW DELHI, March 25: Discrepancy in National AIDS Control Organisation (NACO) data on HIV and AIDS patients has landed the Northeastern States and the non governmental organisations (NGOs) in an embarrassing position, with experts questioning the estimates that the region has the highest HIV incidence in the country. That the ongoing controversy over the NACO's figures is likely to only turn bitter in coming days was evident from the heated exchanges between the AIDS workers from the region and experts at a seminar on "Reality and Myth: HIV-AIDS in Northeast India." The seminar organised by the Centre for Northeast Studies and Policy Research founded by Sanjoy Hazarika had drawn prominent social workers, experts and state government representatives from the region and representative of Union Health Ministry, research organisation, and foreign donors. While research organisation like Joint Action Council Kannur (JACK) termed it, Manipur & HIV-AIDS: The 15 year hoax', social worker and prominent AIDS expert from the State, Khomdon Singh Lisam of Manipur AIDS Control Society (MACS) alleged that the controversy was created by vested interest and was a conspiracy against the region. The bone of contention is NACO national surveillance date, which claimed that Manipur and Northeast has the highest HIV incidence in the country. A declaration that it disowned in its latest Sentinel surveillance data stating that Manipur has among the lowest HIV estimates in the country. JACK's apprehension was echoed by none other than K Srinivasan, executive director, Population Foundation of India, who quoting Registrar General of Birth and Death said Manipur has among the lowest death rates in the country. The population expert also wanted to know if people were dying in large number in Manipur because of AIDS, why has the State not seen high death rates? Even as the experts were fighting it out, the representative of NACO, JVR Prasada Rao, additional secretary, health and Project Director NACO, apparently sensing trouble kept away despite having confirmed his participation. Says Purushothaman Mulloli of JAC, "a certain degree of unreliability is to be expected in any surveillance data, but flaws we had high-lighted in NACO's surveillance data reveal that it was not only unreliable but was clearly a matter of deliberate fraud and manipulation of figures." In December 1996, Manipur was reported as have the second highest rate of HIV infection in the country - with a sero-positivity of 91.51 HIV cases per 1000 people (9.1%). Two years later in 1998, it went on to occupy the unique position as the State with the highest number of HIV infections, with a shocking figure of 177.7 per cent cases per 1000, overtaking Maharashtra, which had the highest AIDS cases in the country. However, the Sentinel Surveillance data released last year revealed that Manipur had an estimated 4,079 HIV infected persons in 1998. Going by an adult population of 9.1 lakh in the State, the estimated HIV cases works out to sero-positivity of only 4.3 HIV cases per 1000 in Manipur, Mulloli pointed out. Even more interesting was the UNAIDS statement which claimed that HIV infection has reached 'general type epidemic level in Maharashtra, Andhra Pradesh, Tamil Nadu, Karnataka and Meghalaya, with no mention of Manipur. The JACK argues that direct result of NACO's assertion led to bilateral agencies and international donor agencies rushing to the rescue of the Northeast - to create thousands of studies supporting and perpetuating this myth through national and international NGOs, out of which many were non-existent NGOs. The HIV flashpoint resulted in a dramatic increase in the flow of funds into the NGO and the State government, with the NACO pumping in grants. Grants to Manipur for instance doubled from Rs 15 crore in 1997-98 to Rs 35.23 crore, in 1999-2000. Similarly contribution to NACO'S got funds worth Rs 1,425 crore from foreign agencies including the World Bank. Challenging this argument was Lisam of the MACS, who claimed that AIDS was becoming a number one killer of young people in Manipur. He claimed that Manipur, which has hardly 0.2 per cent of India's population, has recorded sero-prevalence rate, which is at least six times higher than that of Maharashtra and 20 times higher than Tamil Nadu. He claimed that as of February 28, a total number of 11,359 HIV positive cases out of which 799 are full blown ones was reported out of the 75088 blood samples screened giving a sero-positivity rate of 151.28 per 1000. Citing official records, he pointed out that all districts of the State were affected. Lisam who has been doing pioneering work in the field was also the moving force behind the State framing AIDS policy in 1996, the first State in the country to formulate such a policy. Lisam also dismissed the claims made by his detractors as attempts to gain cheap publicity, saying that perception and reality of the problem is more important. "Today one in every eight persons in Manipur is infected by AIDS," said. While allegations and counter allegation flies thick and fast, it is the people of the region who appear to have suffered the most. For instance, thousands of youngsters in Manipur have been put behind bars, some even in private jails for having HIV. A perception has gained ground outside the region, as a result of which, people from north-east are eyed with suspicion. For instance, in the capital it is now a common practice for hospitals to subject patients from the Northeast to HIV test.