Editor,
The reported 574 new HIV infections in Meghalaya in the first quarter of 2026 should prompt more than another round of awareness campaigns. It should trigger an evidence-based review of whether the State’s resources are reaching the points where they can prevent new infections, expand testing and ensure timely treatment.
Meghalaya needs a measurable, accountable and coordinated response. The State should consider a Chief Minister-chaired HIV Elimination Mission and Control Task Force bringing together health officials, epidemiologists, laboratory specialists, district coordinators, data experts, community representatives, traditional and church leaders and independent technical experts. A defined budgetary allocation would give the Mission both resources and accountability.
The immediate priorities should be practical: HIV self-testing, mobile testing in remote communities, voluntary index and partner testing, harm-reduction services and rapid test-to-treatment pathways. Meghalaya should also integrate HIV and tuberculosis services. Every HIV-service interaction should therefore become an opportunity for TB screening, backed by prompt treatment and continuity of care.
Prevention of mother-to-child transmission deserves particular attention. Pregnant women should receive integrated screening for HIV, syphilis and hepatitis B, with appropriate testing for other infections, timely treatment and proper newborn follow-up.
Mental-health support must also become part of HIV care. A new diagnosis can bring fear, stigma and isolation. Counselling and psychosocial services, including appropriate participation from institutions such as MIMHANS, should be integrated into treatment. Private hospitals and laboratories should also be linked to secure reporting and referral mechanisms.
Civil society has an equally important role. Churches, community organisations, traditional institutions and public influencers can replace stigma with scientifically accurate information. Law enforcement should address illicit drug and syringe networks without discriminating against people living with HIV or interfering with consensual adult behaviour.
Above all, the response must remain grounded in law. The HIV and AIDS (Prevention and Control) Act, 2017 protects people living with HIV from discrimination and safeguards confidentiality and informed consent. Fear of disclosure must never become a barrier to testing or treatment.
This need not begin with an expensive State-wide overhaul. Meghalaya could undertake an 18-month pilot in three high-burden districts, establish baseline indicators and publish quarterly performance data. Success should be measured by testing coverage, treatment initiation, retention, viral suppression and prevention of new infections not merely by the number of awareness programmes conducted.
Shahin Yusuf
Guwahati, Assam
