BIHAR GOVERNMENT STRUGGLES TO ERADICATE POLIO AND FACES

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

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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