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UNCLAS SECTION 01 OF 02 KOLKATA 000291 
 
SIPDIS 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: PHUM KHIV SNAR TBIO IN BM
SUBJECT: NORTHEAST INDIAN STATE MIZORAM STRUGGLES WITH NEAR EPIDEMIC 
LEVELS OF HIV/AIDS 
 
 
¶1.  (U) Summary:  From August 28-30, ConGen visited the 
northeast Indian state of Mizoram to assess the state's social 
issues.  The state borders Burma and has a relatively small 
population of around one million people.  While literacy is high 
at over 88 percent, the state economy is weak and relies on 
central government funds and small-scale agriculture.  Due to 
the state's proximity to Burma, illicit narcotics and related 
public health issues such as HIV/AIDS are persistent problems. 
Mizoram Public Health officials expressed concern that the state 
HIV/AIDS prevalence rate continues to fluctuate around epidemic 
levels, and presently stands at 0.9 percent of the population. 
(Note:  HIV/AIDS prevalence is characterized as at epidemic 
levels when infections are estimated to be 1.0 precent of the 
population or higher.  End Note.)  HIV/AIDS infections have been 
fueled by the high number of intravenous drug users (IDUs), 
estimated by State Aids Control Society Director to be 
approximately 10,000. However, HIV/AIDs has moved into the wider 
population as most infections are now sexually transmitted. 
Because of Mizoram's relative isolation and travel restrictions 
placed on visitors, little domestic or international focus has 
been directed at addressing the problems of HIV/AIDS and illegal 
narcotics.  To be truly comprehensive and effective, USG 
engagement with India on HIV/AIDS and on countering illegal 
narcotics should incorporate support to Mizoram and the 
Northeastern Indian states.  End Summary. 
 
¶2.  (U) Mizoram has a serious HIV/AIDS problem, with HIV/AIDS 
infection rates persistently fluctuating near epidemic levels. 
Mizoram State Aids Control Society Project Director Dr. K. 
Ropari told ConGen that the estimated state HIV/AIDS prevalence 
rate based on a survey of sentinel groups, such as ante-natal 
women, IDUs and others, was presently at 0.9 percent for 2007. 
This latest figure was an improvement over 2006's prevalence 
rate of 1.8 percent.  However, previously the rate was 1.0 
percent in 2005 and 2.0 percent in 2004.  Dr. Ropari felt that 
although infections were down, the persistent fluctuations in 
annual rates indicated that Mizoram could easily reach epidemic 
levels as in previous years. 
 
¶3.  (U) Dr. Ropari expressed frustration that the National Aids 
Control Organization (NACO) did not see the HIV/AIDS problem in 
Mizoram as serious.  NACO's focus on the six states with 
persistent epidemic levels of HIV/AIDS infections meant that 
Mizoram did not receive needed assistance from the GOI.  State 
Health Minister R. Tlanhmingthanga echoed Dr. Ropari's concerns, 
commenting that while he appreciated NACO's assistance, the 
funds have been limited.  He attributed this also to the state's 
small population size, saying, "The [absolute] numbers as 
compared to other states seems low as our state's population is 
below one million."  Tlanhmingthanga said that more support was 
needed for hospice care, efforts to limit mother to child 
transmission, and awareness raising among high risk groups such 
IDUs, sex workers and truck drivers.  He also commented that 
presently no international NGOs were working in Mizoram on 
HIV/AIDS, but that the state would welcome and support such 
assistance. 
 
¶4.  (U) Tlanghmingthanga also observed that initially infections 
were predominantly found among IDUs and related to needle 
sharing, but were now mostly sexually transmitted and occurring 
to a greater extent among the general populace.  (Comment: 
Mizoram's experience of infections shifting from intravenous 
drug use to sexual transmission is a typical pattern in the 
other Northeast states with epidemic levels of HIV/AIDS -- 
Manipur and Nagaland.  International health professionals and 
organizations assessing the HIV/AIDs situation in India often 
continue to mischaracterize the problem of HIV/AIDs as limited 
to the IDU population.  The fact that HIV/AIDS infections have 
migrated out of the IDU community to the broader community in 
the Northeast is a reflection of the failure to address the 
problem when it was predominately limited to the one risk 
behavior of sharing intravenous needles.  In addition, the 
persistent mischaracterization of the problem as isolated to 
IDUs indicates the lack of general awareness about HIV/AIDS 
trends in the Northeast.  End Comment.) 
 
KOLKATA 00000291  002 OF 002 
 
 
 
¶5.  (U) According to the Mizoram State AIDS Control Society, 
from October 1990 to July 2007 a total of 41,011 blood samples 
were screened.  Of these samples, 2,141 were HIV positive (1277 
men and 864 women.)  The statistics also show that out of the 
2,141 HIV cases 773 were IDU related, 1,170 were sex related, 85 
were ante-natal and about 113 fell in the "other" category.  The 
total number of deaths due to AIDS in Mizoram during the time 
period was 141, of which 83 were males and 58 were females.  Dr. 
Ropari added that at present there are 219 AIDS cases, (125 are 
male, 58 female).  The Society has initiated a drive to promote 
condoms and generate awareness about the disease.  Among the 
estimated 10,000 drug users in the state, 26 IDU projects are 
already in progress.  Local organizations have also sought to 
help.  The Young Mizo Association, which has close ties to the 
state government, has enlisted many of its volunteers to 
campaign to counter drug use and drug trafficking in Mizoram. 
 
¶6.  (U) Comment:  Mizoram is almost exclusively dependent on the 
support of NACO for its HIV/AIDS programs.  However, as 
evidenced by comments of the State Aids Control Society Director 
and Health Minister, NACO's support is not sufficient to meet 
the state's needs.  Their comments appear substantiated by the 
fact that infections remain consistently at or above epidemic 
levels.  The absence of a significant international public 
health presence in Mizoram is a reflection of how the Northeast 
region is often forgotten in the broader discussion of the 
HIV/AIDs situation in India. 
JARDINE