Manipur and Mizoram: Critical Battlegrounds in India's HIV Control Mission
As India marches toward a critical December 2027 deadline to achieve HIV control, two northeastern states—Manipur and Mizoram—have emerged as pivotal battlegrounds in the nation's fight against the epidemic. With prevalence rates that dramatically overshadow the national average, these states pose a significant threat to India's ability to meet its global health commitments.
Alarming Statistics Highlight the Crisis
Together, Manipur and Mizoram account for nearly 50,000 people living with HIV. This staggering figure represents approximately 2% of India's total burden of 25.61 lakh PLHIV, despite these states comprising less than 0.5% of the country's total population. The disparity underscores a concentrated epidemic requiring urgent, targeted intervention.
In a recent three-day review workshop convened by the National AIDS Control Organisation (NACO) in Guwahati, health officials confronted a stark reality. Mizoram's adult HIV prevalence stands at a staggering 2.75%—nearly 14 times the national average of 0.20%—making it the worst-affected state in India. Manipur follows closely with a prevalence of 0.81%, which is four times the national rate.
NACO's Strategic Review and District-Level Focus
The workshop, held under Mission AIDS Suraksha, saw detailed deliberations focused on 12 districts in Manipur and 11 districts in Mizoram. In Manipur, districts including Bishnupur, Chandel, Churachandpur, Imphal East, Imphal West, Thoubal, and Ukhrul were reviewed to assess micro-level indicators and identify gaps in:
- Testing procedures
- Linkage to treatment
- Retention in care
- Viral suppression
According to a statement from the Ministry of Health and Family Welfare, Manipur, with an estimated burden of over 23,000 people living with HIV, remains a priority state in the national HIV response.
Similarly, Mizoram, with an estimated burden exceeding 26,000 PLHIV, underwent extensive review. Eleven districts—such as Aizawl, Champhai, Kolasib, Lunglei, Serchhip, Mamit, and Siaha—were assessed for district-specific strategies, with particular emphasis on:
- Intensified testing strategies
- Index testing
- Improved linkage to treatment
- Scaling up OST (Opioid Substitution Therapy) services
- Focused interventions among youth and high-risk groups
Leadership Calls for Data-Driven Action
Addressing participants on the second day of the workshop, Dr. Rakesh Gupta, Additional Secretary and Director General of NACO, emphasized the need for decisive action. "Granular planning, data-driven monitoring, and strong local ownership are essential to bend the curve of new infections in high-prevalence states like Manipur and Mizoram," he stated.
Dr. Gupta further highlighted India's clear, time-bound goal: "India has set a clear and time-bound goal to attain HIV control by December 1, 2027. Every high-priority district must translate this commitment into measurable outcomes aligned with the 95-95-99 targets."
The 95-95-99 Targets: A Roadmap to Control
The primary objective of the NACO workshop was to strategize and accelerate progress toward achieving the global 95-95-99 targets. These targets aim to ensure that:
- 95% of all people living with HIV know their HIV status
- 95% of those diagnosed receive sustained antiretroviral therapy (ART)
- 99% of those on treatment achieve viral suppression
Special attention during the review was given to bridging gaps in early detection and strengthening follow-up mechanisms to ensure treatment adherence and viral suppression. This comprehensive approach is critical for turning the tide in these high-burden regions and safeguarding India's progress on the global health stage.
