Reaching to the unreached and hard to reach areas for providing prevention, care and treatment services to the PLHIV living in the easternmost past of India is now possible and accessible. Noklak, earlier a block within Tuensang district in Nagaland (North eastern state in India), has now been demarcated as an independent district. Inaugurated on January 20, 2021, Noklak is the youngest and the 12th district of Nagaland, located in the easternmost part of India along the IndoMynamar border. With an area of around 164.92 kms, there are 13 villages located in hilly region of Noklak district with a population of 59300 (2011 census). Since 2002, a TI NGO (KBCA Noklak) is implementing harm reduction program among People with Injecting Drugs (PWIDs), reaching to around 320 PWIDs. Heroin is the choice of drug among PWIDs in this area. Though the distance to villages from Noklak town is not far, the farthest being 45 Km away from Noklak town, it is very challenging for the Outreach team of KBCA to travel due to absence of proper motor able roads and unavailability of public transport.

There has been a constant need to reach the hard-to-reach population in this district and over the years strategies like Satellite OST (Opioid Substitution Therapy), Sub Drop in Centres (DIC) and Secondary Distribution of Needle and Syringe (SDNS) have been effectively implemented with quality outcomes. There still remains the needs for focused service delivery solutions for providing HIV treatment services like ART initiation and delivery. To reach the unreached and the hard-to-reach PWIDs in the district, an approach is being proposed where motor bikes, which
are the most convenient methods of conveyance, could be used for outreach. This was a cooperative model with the vehicles being procured and refurbished by the Nagaland State AIDS Control Society (NSACS) for sustainable solution, and logistic support being provided by Project Sunshine, I-TECH India. Field staffs, supported by I-TECH India, work closely with the outreach team of the TI NGO and two motorbikes are being provided for outreach. This innovation will not only identify the new PWID (and other vulnerable population) and reach to the unreached and
hard to reach areas, but also strategize linkages and initiation to ART for all positive PLHIV. Mobile HIV testing camps are being conducted and harm reduction commodities are being distributed. Service delivery points i.e., the government facilities (such as PHCs / CHCs / Sub Centres) are being identified and utilized to provide the services.

This intervention is expected to provide HIV prevention and harm reduction services to the difficult to reach People Who Inject Drugs in Noklak along with clinical and lab facilities, ensuring adherence to medicines (ART and OST).

With this new intervention, the beneficiaries are now happy as they can easily access the services now. Some quotes from the beneficiaries –

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