NACO number trick — Manipur slides from top to bottom on HIV list

NEW DELHI, OCTOBER 14: The National AIDS Control Organisation (NACO), the only national body authorised to make projections about HIV posi...

NEW DELHI, OCTOBER 14: The National AIDS Control Organisation (NACO), the only national body authorised to make projections about HIV positive cases in the country, has done something remarkable.

When it changed its sampling procedure, Manipur from being the state with the highest rate of HIV positive cases in the country overnight became thestate with the lowest rate. From 177 affected per 1,000 people to 20 per 1,000 (figures for 1998).

The organisation which functions under the Union Health Ministry is yet to give a convincing reason for the roundabout in the figures, nor has it fixed responsibility for it. NACO officials brushed off the mistake on the surveillance system of counting reported HIV cases. Despite repeated calls and a faxed questionnaire, Director J.V.R.Prasada Rao refused to explain the disparity.

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According to NACO’s earlier statistics, Manipur had witnessed almost doubling of HIV positive cases in the period between 1996 and 1998. NACO reports said the state had 91.52 cases per 1,000 people in 1996 which rocketed to 177 per 1,000 in 1998.

The huge leap is apparently due to some error committed in the sampling.

In 1996, NACO reported that a total of 40,557 people were screened in Manipur for HIV since 1986. Of these 3,712 were found positive. The incidence rate was accordingly calculated as 91.52 per 1,000 people.

In 1998, NACO reported that the total numbers screened since 1986 was only 29,975. No reason was given on how the figures — which are to be cumulative — suddenly dropped. The number of HIV positives (again a cumulative figure) were, however, shown to have increased to 5,327. The incidence rate obviously shot up — to 177.71 per 1,000 people.

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The discrepancy in figures were noticed only after a Delhi-based Non-Governmental Organisation JACK raised the issue recently.

Manipur Health Secretary Naba Kishore Singh expressed surprise at the NACO error and said the organisation has no other source of data other than the state AIDS society. And the state had screened 68,000 people until now.

Since July, NACO has officially adopted the system of making estimates on the basis of random blood samples collected at 132 sentinel sites in the country.

While the difference in system can explain the difference in figures for 1998, it still does not explain how the total number of people screened dropped in 1998.

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What is significant is, consequent to NACO’s report which projected Manipur as being on the verge of an AIDS epidemic, the flow of AIDS-related funds into the organisation and the state increased dramatically.

While grants released for Manipur by NACO in 1997-98 was Rs 150 lakh, it went up to Rs 245 lakh in 1998-99 and to Rs 352.38 lakh in 1999-00.

With Manipur and the entire northeast being projected in such gloomy colours, NACO got funds worth Rs 1,425 crore for the second phase of its National AIDS Control Programme beginning last year. Of this Rs 1,155 crore is a World Bank loan which India must return, and Rs 265 crore is assistance from American and British funding agencies USAID and DFID.