Manipur with its unique culture and the excellent performance of its sports-persons have been widely acclaimed. Unfortunately, it is also the home to various issues and problems: unemployment, insurgencies movement, rampant corruption, drug abuse, AIDS, political instability, ethnic unrest and threat to its territorial boundary. With this in mind, the article is confined to look at the drug abuse and HIV/AIDS scenarios as well as the efforts undertaken to tackle the twin menace in this troubled torn state.

Part I

Manipur, which has an international border of about 350 kilometers with Myanmar, became the victim of international drug smuggling as the notorious traffickers found the route through this point of international border as a soft route. With national roads leading directly to nations of the “Golden Triangle” of Southeast Asia, drug trade and abuse is widespread especially in India’s northeastern state of Manipur. This is further complicated by the rise in HIV/AIDS among young drug users. The major forms of addiction in the beginning were mild tranquilizers and methaqualone, followed by inject-able morphine and pethidine. In due course of time, heroin locally known as Number 4, became the most widely used drug among the young drug users, and heroin addiction reached the explosive stage in 1984 (AIDS ALERT, 2001). Besides it, drugs like spasoproxybone, ganja, alcohol, phensedyle, opium, cough syrup, nitrazepam, detroproxythene and buprenorphine have also being abused. Generally, the young drug users started taking drug, orally either by smoking or inhaling and in due course of time switched over to injection in which they shared unhygienic injecting equipments like needles and syringes.

Easy availability of heroin and other illicit drugs are solely responsible for high addiction rate in the state. In addition, pharmaceutical drugs are also easily available to the youngsters. Available data, though contradictory, indicate an estimated 40,000 drug addicts in the state, of which 20,000 have been reported to be Injecting Drug Users (IDUs). However, one report by UN-AIDS put the number of Injecting Drug Users (IDUs) to around 40,000 (Frontline, August, 2.2002). Study conducted jointly by the Ministry of Social Justice & Empowerment (MSJ&E) Government of India and United Nations Drug Control Program (UNDCP) in 2000-01 found that out of the 308 drug users interviewed in Imphal, the capital city of Manipur, the proportion of Injecting Drug Users (IDUs) were 92 per cent; of which 10 per cent abusers were females; all of them were literate, of which 24 per cent were college educated drug users; 61 per cent were unemployed; 71 per cent were heroin users and 23 per cent have tested HIV (MSJ&E and UNDCP: 2002).

Along with the menace of drug addiction, the state has also witnessed an alarming rise of HIV/AIDS infected persons, which has been the most serious public health problem, and AIDS has become the number one killer of young people. Manipur is also known as the epicenter of AIDS in the northeastern states. It is the third highest, next to Maharashtra and Tamil Nadu in regards to the total number of HIV positive cases. However, if we calculate the sero-surveillance rate per one million populations, the sero-prevalence rate of Manipur is at least 6 times higher to Maharashtra and 20 times to Tamil Nadu (AIDS Alert 2001).

The most important route through which HIV is transmitted here has been the sharing of infected needle among the IDUs (72.76%); whereas in other parts of India more than 74.18 per cent HIV positives have been through sexual transmission. Quality testing of heroines, indulged by drug traffickers themselves also to some extend contributed the epidemic as they traveled to and fro between Manipur and Myanmar. Commercial sex workers are also vulnerable to HIV and represent a relatively significant core group for transmission of the virus through their clients in the state. In 1997, 60 to 70 per cent of HIV infection cases were found among the injecting drug users and the percentage has however come down after the successful intervention measures and AIDS campaigns done by State Government and various AIDS-NGOs in the state. Manipur is the first and only state, which has a written State AIDS Policy in India.

Unfortunately, HIV/AIDS epidemic is no longer confine to the Injecting Drug Users’ (IDUs), as it has spread to their sexual partners; to their children and to others as well. An increasing number of people infected in the state belong to the younger and working age groups. It is reported that, the HIV sero-prevalence rate among the pregnant women is too raised alarmingly. More than 90 per cent of the HIV positive women got infected from their husband (AIDS Alert, 2001). The number of AIDS widows as well children have also increased. It is estimated that around 1000 children have been affected with HIV/AIDS in the state by December 1, 2001 (UNDCP E41, January 2002).

Out of total 95,734 blood samples screened between September 1986 to April 2003, a total of 15,166 HIV positive cases (2,297 females), and 2,106 AIDS cases (303 death) have been reported giving a sero-positively rate of 158.42 per 1000 blood samples screened (Table 1). Of the 11,189 HIV Positive cases (Sero-surveillance) young people below the age of 30 years constituted around 68 per cent of the total HIV positives (Table Two). All the districts in the state have been affected, where Imphal East and Imphal West districts accounted to 68.19 per cent of the total HIV positives followed by Thoubal and Churachandpur districts, which accounted to 9.49 per cent and 5.68 per cent respectively.

Part II

Recognizing the seriousness of the multi-faceted implications of the incidence of alcoholism and drug abuse in the country, the Ministry of Social Justice and Empowerment, Government of India launched a scheme for prohibition and drug abuse prevention in the year 1985-86. Since than the ministry has been promoting a community based approach towards the identification, treatment and rehabilitations of addicts. In the larger social context, a major thrust has to be given to preventive education so as to ensure that those at risk are helped before they reach a point of no return. Beginning with 7 Centers established in Delhi in 1985-86, the total number of such Centers functioning nationwide by 2000 had reached 425. These included 160 CCs and 292 DCs. Likewise, by 2000; there were altogether 27 such Centers in the state of Manipur (14 CCs and 13 DCs) being financially assisted by the ministry.

Besides, huge amount of money have been spent to control the spread of HIV/AIDS infection in the state over the year. There are various national and international agencies like the National AIDS Control Program (NACO) being the major source of finance, UNDCP, UNAIDS, OXFAM and SIDA have been working in the field, are supporting various non-governmental organizations (NGOs). The Manipur AIDS Control Society (MACS) shoulders the sole responsibility of receiving and disbursing funds from NACO. The expenditure also gradually increased from Rs. 121.88 lakhs in 1996-97 to Rs. 607.48 lakhs in 2001-2002.

However, despite the effort of various agencies the twin menaces continues to spread alarmingly. A horde of questionable NGOs gobbling up unaccounted sums of money and preventive strategies like creating awareness are executed lackadaisically. The Manipur AIDS Control Society has been repeatedly hauled up by the state auditors for diverting vital AIDS funds to other health programs. There are about 100-odd AIDS NGOs in the state. No doubt, there are NGOs doing excellent jobs. Nevertheless, these NGOs also face problems relating to accommodation, funding and manpower. There are complaints about insufficient funding that to erratic release of funds and the lack of public support among others. For better result, such NGOs need to be strengthened with sufficient and timely funding. Side by side their activities should be closely monitored and the non-performing NGOs should be identified and funding stopped. 

It is not to surprise that the outlawed organizations of the state like Revolutionary Peoples’ Front (RPF) and Kanglei Yawol Kanna Lup (KYKL) also stepped up their campaign against drug abuse. In September 2002, two drug traffickers were executed by the banned RPF. They have also from time to time punished a number of drug addicts or instruct them to get admitted in the Rehabilitation Centers as well. The banned Kanglei Yawol Kanna Lup (KYKL) has even banned the sale and use of tobacco and its related product throughout the state from April 14, 2003. However, it is too early to comment on how effective their campaign is? The twin problems can be effectively tackled only when the general public cooperate and participate with the agencies working in the field. However there is lack of public interest and participation. The community participation can be enhanced and ensured through the following steps:

(I) By creating awareness about the evil through campaigns, seminars and workshops. The target population for educational measures for prevention should be college/university students/ rickshaw pullers/ truck drivers.

(II) By actively involving the government agencies and the NGOs.

(III) By interacting and involving the opinion leaders;

(IV) By ensuring a positive   role of the media such as newspaper, radio, TV etc.

(V) By actively involving the youth; and

(VI) By ensuring women’s’ involvement.

The various local women organizations like Meira Paibis or women torchbearers should intensified their fight against the evils of alcoholism, drug addiction and also AIDS in association with various local youth bodies. The participation of the youth in the campaign is a must.

Effort should be made so that illicit drugs are not easily available, for this adequate security along the Indo-Myanmar border, though an expensive affair is the need of the hour. Besides, controlling illegal drug trafficking it will control other illegal activities from across the border. Added to this legal (pharmaceutical) drug like phensedyle, cough syrup, sposmoproxybon etc. must be sold very strictly. The situation even compels the need for appropriate law for giving life imprisonment to the drug traffickers and peddlers.  Policemen and other law enforcer found working in collusion with the drug peddlers should not spared but promptly punished. 

To sum up, the solution to the problem requires rethinking and re-planning. The confusion created by drug abuse and HIV/AIDS, if not tackled in time will furthered confused the Manipuri society. It is urgent responsibility for all concerned to have a coordinated effort to check the menaces rather than leaving the whole task to few individuals or agencies. Moreover, the alleged secret understanding between politicians/ law enforcer with the drug traffickers/ peddlers should be closely watched and punished.

References

1. Rapid Assessment Survey of Drug Abuse in India, Ministry of Social Justice & Empowerment and United Nations Drug Control Program, Regional Office for South Asia, 2002, New Delhi.

2. National AIDS Control Program, Manipur 2000-2001, Manipur AIDS Control Society (Status Report), 2003, Imphal.

3. AIDS Alert, Vol. 3, 2001, Manipur Aids Control Society, 2001.

4. Frontline, August 2, 2002, Chennai.

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Table No.1 Epidemiological Analysis of HIV/AIDS in Manipur (Sept 1986- April 2003)

Courtesy: Manipur AIDS Control Society, Imphal

 Table No. 2 Age-sex proportion of HIV positive cases ( Sero-surveillance)

Courtesy: Manipur AIDS Control Society, Imphal

 Table No.3: District-wise Distribution of HIV positive Cases ( Sero-surveillance)

Courtesy: Manipur State AIDS Control Society, Imphal

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* The author has done PhD, in sociology from NEHU, Shillong and is presently associated with the Institute for Conflict Management, Guwahati/New Delhi...

E-mail: m_amarjeet@rediffmail.com