Veroli Zhimo
The response to HIV is at a pivotal point. While there has been a great deal of talk and excitement about the “end of AIDS,” ground realities underline that resources, political commitment and attention to one of the most devastating epidemics of the times, cannot be sidelined.
Nearly 31 years after the first HIV & AIDS positive case was detected in the year 1990 amongst the injecting drug users (IDUs) by the Indian Council of Medical Research (ICMR), Nagaland has the second-highest adult (15-49 years) HIV prevalence in the country at 1.45%, greater than the national prevalence at 0.22%.
As per statistics in the ‘India HIV Estimates 2019 Report’ by National AIDS Control Organisation (NACO) and ICMR, the adult HIV prevalence in Nagaland was alarmingly seven times the national average while HIV incidence was 16 times that of the national average. Further, 91% of the new HIV cases were through the sexual route.
New HIV infection per 1,000 in 2019 for Nagaland was estimated at 1.55% (adult-1.48%, female-0.68% and children-0.06%), while the number of PLHIV per thousand was estimated at adult - 21.56%; female – 9.99%; and children - 0.89%. AIDS related mortality was at 0.57%.
Besides the outbreak of the COVID-19 pandemic which restricted access to vital services for key populations, a major setback in HIV and AIDS advocacy in the state was the disbanding of the Legislators’ Forum on AIDS (LFA), reportedly due to budget cuts. The move, among others, disconnected elected leaders from the Nodal Department (NSACS) and other local NGO partners and disrupted proactive engagement in the collaborated fight against the HIV and AIDS epidemic.
The other is the delay in appointment of an Ombudsman as mandated by the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act 2017 and the Nagaland HIV and AIDS (Ombudsman and Legal Proceeding) Rule 2019, to redress the grievances of People Living with HIV and AIDS (PLHIVs).
The state government was taken to court over the matter as the Network of Nagaland Drugs and AIDS Organizations (NNagaDAO) and Network of Naga People Living with HIV and AIDS (NNP+) with support from Nagaland Human Rights Law Network filed a public interest litigation (PIL) in the Kohima Bench of the Gauhati High Court. The matter is now sub judice.
It is a known fact that the rights of PLIVs are often violated because of their presumed or known status, causing them to suffer both the burden of the disease and the consequential loss of other rights. In most cases, stigmatisation and discrimination obstruct their access to treatment and may affect their employment, housing and other rights. This, in turn, contributes to the vulnerability of others to infection, since HIV-related stigma and discrimination discourages individuals infected with and affected by HIV from contacting health and social services. Accordingly, those needing information, education and counselling the most, would not benefit even where such services are available.
Across the globe, members of key populations have been fighting for protection under the law, advocating for accessible and affordable treatment and prevention services, and paving the way for human rights advancements.
At an event to felicitate the state Consultant to the now-disbanded LFA on October 23, 2020, Nagaland Minister for Planning and Coordination, Land Revenue, and Parliamentary Affairs Neiba Kronu said that though the LFA would be discontinued, ‘they have passed on the responsibility to the churches under Nagaland Baptist Church Council (NBCC) and Nagaland Development Outreach (NDO), so that continued awareness and education is imparted to the people through various church initiatives.’ Considering the outreach of the church and CSOs/NGOs in the Naga society, it makes sense that such a responsibility would be entrusted to them.
However, amid the COVID-19 pandemic and the alarming statistics, it is pertinent for the state government to realise its bigger role in HIV and AIDS advocacy, if it is to achieve the global goal of ‘ending the AIDS epidemic by 2030.’
HIV and AIDS will not end until the voices of those at the very forefront of the epidemic are not sufficiently heard in the hallways of political power and influence and the inequities in access to social and health services, grievance redressal and all other human rights considerations are not squarely addressed.
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