VZCZCXRO0148
PP RUEHBI RUEHCI RUEHCN RUEHLH
DE RUEHCI #0137/01 0931002
ZNR UUUUU ZZH
P 031002Z APR 06
FM AMCONSUL CALCUTTA
TO RUEHC/SECSTATE WASHDC PRIORITY 0857
INFO RUEHNE/AMEMBASSY NEW DELHI PRIORITY 0795
RUEHBI/AMCONSUL MUMBAI 0314
RUEHCG/AMCONSUL CHENNAI 0314
RUEHKA/AMEMBASSY DHAKA 0183
RUEHKT/AMEMBASSY KATHMANDU 0187
RUEHIL/AMEMBASSY ISLAMABAD 0131
RUEHLH/AMCONSUL LAHORE 0071
RUEHKP/AMCONSUL KARACHI 0073
RUEHCN/AMCONSUL CHENGDU 0010
RUEHGO/AMEMBASSY RANGOON 0109
RUEHPH/CDC CDC ATLANTA GA PRIORITY
RHMFIUU/CDR USPACOM HONOLULU HI
RUEHC/USAID WASHDC
RUEAIIA/CIA WASHDC
RUEHGV/USMISSION GENEVA 0025
RUCNDT/USMISSION USUN NEW YORK 0019
RUEHCI/AMCONSUL CALCUTTA 1047

UNCLAS SECTION 01 OF 02 CALCUTTA 000137 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: EAID ECON SOCI ASEC KHIV IN
SUBJECT: BIHAR GOVERNMENT STRUGGLES TO ERADICATE POLIO AND FACES 
INCREASING HIV/AIDS 
 
 
¶1.  (SBU) Summary.  On March 23 CG had introductory meetings 
with recently elected Bihar Chief Minister Nitish Kumar and his 
senior officials to discuss the new state government's economic 
development, public health and security initiatives.  Kumar and 
other contacts expressed a strong interest in attracting 
investment in agro-business, health care and education.  In 
public health, greater attention was being made to eliminate 
polio in Bihar as it has one of the highest concentrations of 
new infections in the country.  Also, state officials are 
concerned that HIV/AIDS infection rates have been increasing to 
three times epidemic rates in some rural villages.  The 
government is responding to the serious Maoist insurgency in the 
state by attempting more effective social services with a 
program termed "Government at Your Doorstep."  Kumar, his 
ministers and senior officials seem energized to improve 
governance in Bihar but the damage from 15 years of misrule by 
former Chief Ministers Lalu Prasad Yadav and his wife Rabri Devi 
will take time to correct.  End Summary. 
 
¶2.   (SBU) CG met Kumar to personally congratulate him on his 
victory in the November 2005 state assembly elections and to 
discuss his new government's plans.  Bihar is India's poorest 
state, with 43 percent of its population living on less than a 
dollar a day and a child mortality rate of 34.3 percent. 
However, it is the second largest vegetable producing state in 
the country and a leading maize producer.  Because of the 
state's agricultural dominance, Kumar noted he had a strong 
desire to promote agro-business and to revive the dormant sugar 
industry.  In separate meetings, Deputy Chief Minister Sushil 
Kumar Modi, Chief Secretary G.S. Kang and Cooperatives Secretary 
B.B. Shrivastava echoed the CM's comments.  According to Kang, 
Iowa State University has shown interest in joint agricultural 
research with Rajendra Agricultural University, Pusa.  To 
facilitate investment, Deputy CM Modi said that the state 
government would establish a "single window clearing" process to 
expedite establishing businesses.  As a neutral observer, 
Confederation of Indian Industries (CII) Bihar Chapter President 
Pramod Sharma expressed general satisfaction with the new Bihar 
government's initial efforts to promote business and better 
governance.  Kumar and others also expressed a strong interest 
in developing healthcare and education, sectors in which Bihar 
lacks adequate facilities.  Health Minister Chandramohan Rai 
said that construction would start in April 2006 on a major All 
India Institute of Medical Science (AIIMS).  In addition, 
private sector investment in health and education would be 
encouraged. 
 
¶3.  (SBU) Bihar's severe poverty has contributed to serious 
public health problems such as polio and HIV/AIDS.  According to 
the latest statistics from the Bihar office of the United 
Nations Children's Fund (UNICEF), Bihar accounted for 28 of 
India's 63 polio infections in 2005 and cases have been exported 
from Bihar to Jharkhand, Punjab and Nepal.  In January CG 
contacted Chief Secretary Kang to express USG concerns about the 
Bihar government's failure to implement an effective polio 
immunization program.  Since then, the Bihar government, UNICEF 
and the World Health Organization (WHO) have implemented two 
rounds of immunization.  UNICEF Health Officer Dr. Vijay Moses 
said that the new Bihar government is now more serious in 
implementing the immunization programs.  CM Kumar is personally 
monitoring the polio eradication drives and has identified 
preventing new infections as his highest priority.  Kumar has 
also been in regular contact through video conferencing with the 
District Magistrates to impress upon them the importance of the 
immunization drives and he has refused to grant any leaves to 
medical officers during the immunization periods.  Even with the 
increased attention, three new polio cases have been identified 
since the beginning of the year.  Dr. Moses said it was not 
clear whether the recent cases were the result of infections in 
2005, or actually from the 2006.  Additional rounds of 
immunization are planned for April 9 and later in May. 
 
¶4.  (SBU) Disturbing trends are also emerging in HIV/Aids 
infection rates in Bihar.  The lack of adequate health care 
infrastructure has made effective tracking of infection rates 
 
CALCUTTA 00000137  002 OF 002 
 
 
difficult.  Until recently, the National AIDS Control 
Organization (NACO) reported a prevalence rate of .13 percent 
for HIV/AIDS infections in the state.  Two studies published in 
March of surveys done by the Bihar State Aids Control Society 
(BSACS) in 38 districts in July 2005 and December 2005 found a 
dramatically increased prevalence rate of .53 percent.  Bihar 
now has reportedly 8,128 people diagnosed HIV positive and about 
1,070 cases of AIDS.  A senior BSCAS official was quoted by the 
Times News Network as saying, "The rate at which infection is 
spreading, very soon, it may cross the 1 percent prevalence 
rate."  Some districts have infection rates that significantly 
exceed epidemic levels: Sitamarhi and East Champaran have rates 
of 3.7 percent and 2.28 percent respectively.  Health Minister 
Rai noted that the infections are concentrated in areas that are 
a source of migrant labor for the rest of India.  According to 
the Institute of Human Development, New Delhi's report "Rural 
Labor Migration From Bihar," 48 percent of all Bihar households 
reported at least one family member who was a short-term 
migrant.   Bihar appears to be developing into a reservoir and 
potential source of future HIV/AIDS infections for India, just 
as it has for polio. 
 
¶5.  (SBU) Kumar and others admitted that the ongoing Maoist 
insurgency continues to be another major concern.  Kumar said 
that he sees development as the best response to the Maoists. 
By improving his government's delivery of basic services to the 
poor communities most affected by the Maoists, he hopes to dry 
up potential pockets of support.  One of the programs recently 
initiated was "Government at Your Doorstep," in which state 
officials go to villages highlighting various state development 
programs.  The initiative was inaugurated in Jehanabad, where in 
November 2005, 300 Maoists attacked a prison and released all 
the inmates. 
 
¶6.  (SBU) Comment:  Kumar and his senior officials appear 
serious in wanting to implement positive change in Bihar. 
However, the damage of 15 years of poor governance by former 
Chief Ministers Lalu Prasad Yadav and his wife Rabri Devi will 
require significant effort and time to correct.  Fundamental 
problems will be difficult to resolve, such as the lack of 
development, inadequate health care and a persistent insurgency. 
 Kumar's initial efforts to address polio are encouraging and 
will hopefully bring an end to further infections in the state. 
However, HIV/AIDS constitutes an emerging issue that given the 
lack of resources and awareness will see little immediate 
improvement.  If the pattern holds with HIV/AIDs as was 
demonstrated in the case of polio, HIV/AIDS infections will 
likely increase and Bihar will potentially become a source for 
infections elsewhere in India. 
JARDINE