Syllabus: GS-II & V: Health

Why in the News?

Assam is witnessing an alarming spike in HIV infections among Injecting Drug Users (IDUs), with nearly 60% of new cases now linked to unsafe needle use. This shift signals a dangerous convergence of drug trafficking and public health crisis, demanding a coordinated strategy.

Twin Strategy for a Drug-Free Assam

Assam’s growing drug problem is no longer limited to law enforcement—it has become a serious public health challenge, especially with the rise of injecting opioid use among youth. The HIV Estimation Report 2025 provides critical data: while heterosexual transmission has drastically fallen from 77% (2021) to 27% (2025–26) due to behavioural awareness, unsafe needle sharing among IDUs now accounts for nearly 60% of new HIV cases.

This epidemiological shift means that AIDS prevention efforts and anti-drug operations cannot work in silos. The state needs a unified twin strategy that addresses both illicit drug supply and unsafe drug consumption patterns.

Understanding the Rising Drug-HIV Nexus

• Assam has seized illicit drugs worth INR 4,000 crore (2016–2025).
• Heroin and brown sugar alone account for ₹2,174 crore, showing a disturbing rise in opioid availability.
• Persistent social stigma against HIV drives infected IDUs underground, leading to hidden networks of unsafe needle-sharing.
• Drug consignments that go undetected continue to circulate among youth, feeding the crisis.

Key term – Injecting Drug Users:
People who inject narcotic substances like heroin directly into the bloodstream, often using contaminated needles, resulting in high HIV/Hepatitis C transmission risk.

Progress and Gaps in HIV Prevention

Assam has made strong gains in the first of the UNAIDS 95-95-95 goals:

• 95% of people with HIV knowing their status – Assam reached 91%, up from 52% in 2022–23.

But the other two goals—

• 95% of detected cases on Antiretroviral Treatment (ART), and
• 95% achieving viral suppression

—cannot be achieved if new infections continue to rise among IDUs.

Twin Strategy for a Drug-Free and HIV-Safe Assam

A. Cut the Supply Chain: Strengthen Drug-Law Enforcement

• Intensify operations by Assam Police, Narcotics Control Bureau, and central agencies.
• Focus on cross-border trafficking routes from Myanmar via Manipur.
• Increase riverine surveillance, especially along Barak and Kopili systems.
• Target drug cartels, transport networks, and local peddling modules.
• Use technology-based tracking, night-vision drones, and intelligence mapping.
• Enforce stringent provisions of the Narcotic Drugs and Psychotropic Substances Act (NDPS Act).

B. Reduce Demand: Harm-Reduction & Public Health Approach

Harm Reduction Strategy (Key Term):
A globally accepted approach that reduces risks associated with drug use—without necessarily requiring immediate abstinence.

Key components:

• Expand Opioid Substitution Therapy (OST) under the National AIDS Control Programme.
• Ensure sterile needle-syringe distribution, safe disposal units, and mobile outreach for hidden IDU groups.
• Strengthen community-based awareness to counter HIV stigma + drug stigma.
• Enable peer-led interventions through credible NGOs.
• Integrate mental health support and counselling at community health centres.

Role of Government Schemes

Nasha Mukt Bharat Abhiyaan

• Focuses on youth outreach, school-based sensitisation, and district-level anti-drug committees.

National Action Plan for Drug Demand Reduction (NAPDDR)

• Funded by Ministry of Social Justice and Empowerment.
• Supports rehabilitation centres, awareness campaigns, and capacity-building.

Both schemes must now pivot to address injecting drug use + HIV intersection, not just general addiction.

Need for Innovative Approaches

• Street-level mapping of hidden IDU clusters.
• “Needle-exchange vans” for remote pockets.
• Anonymous drop-in centres for HIV testing.
• Social-media-based campaigns tailored for youth.
• Community vigilance against trafficking networks.

A critical message: Stigma kills. Silence spreads infection.
Ending HIV requires bringing IDUs into the healthcare system—not driving them underground.

Conclusion

Assam’s challenge lies at the intersection of public health, internal security, and social behaviour. A drug-free Assam will require simultaneous action on the supply and demand sides, integrating police operations with a compassionate, science-based health strategy. Only a sustained, coordinated approach can protect the youth and secure Assam’s future.

Exam Hook: Key Takeaways

• Rising HIV infections among IDUs: 60% of new cases in Assam.
• Sharp fall in heterosexual transmission: 77% → 27%.
• Illicit drug seizures (2016–2025): ₹4,000 crore.
• UNAIDS 95-95-95 targets crucial for 2030 goals.
• Harm reduction + NDPS enforcement = essential twin strategy.

Mains Question

“Assam’s fight against drug abuse must integrate public health interventions with aggressive anti-trafficking measures.” Discuss with reference to the rising HIV cases among injecting drug users.

Source