I wish to nominate Dr Langkham as a worthy recipient of the inaugural Dignity and Right to Health award of the ICMDA.

 

Dr Langkham has addressed the health needs of people in adverse and extreme circumstances with great compassion during the last fifteen years in India.

 

A public health physician, Dr Langkham was involved in early responses to the twin epidemics of drug use and HIV in his hometown of Churachandpur, Manipur, in the early 1990s. His initial involvement was to assist his Church in the establishment of a compassionate Christian response to those addicted to heroin whilst a District Health Officer with the Manipur State government, India.

 

I first met Dr Langkham in 1993 in this very setting. Along with colleagues in India we visited the northeast region of that country to identify ways to support community-based responses to the emerging HIV epidemic. What followed was the establishment of an inter-denominational and inter-tribal local response to HIV prevention among youth who injected drugs. Dr Langkham along with his colleague, Dr Muana, resigned his government post to pioneer this work and establish Project SHALOM under the auspice of the Emmanuel Hospital Association (EHA). He was two years short of receiving a full government pension.

 

Project SHALOM provided the first comprehensive response to HIV and AIDS in the region of India that shares an international border with Myanmar. Dr Langkham and colleagues initiated a program of HIV education and awareness among youth, including in schools; undertook to educate the Churches concerning the nature of AIDS and appropriate Christian responses; established home based care for those with HIV infection and/or illness associated with drug addiction; initiated a program of drug detoxification; and pioneered the first needle and syringe exchange program in India.

 

Home-based care brought for those domiciled and ill with HIV infection and AIDS compassionate care in familiar settings at a time when hospitals were hostile places often excluding those in need. It also provided support to care providers, usually family members who shared the stigma attached to their ill son, brother or husband.

 

The Project extended prevention services and care into the community through a program of outreach that extended to homeless addicted youth and a smaller proportion who were female clients engaged in street based sex work in support of their addiction.

 

In the mid 1990s harm reduction was a very controversial approach to HIV prevention among people with addiction to drugs. Advocating for the needs of addicted youth, many infected with HIV, Dr Langkham was able to bring the Christian church, wider community members and their leaders, law enforcement officers and government legislators into a deeper understanding of the important contribution of harm reduction to a truly comprehensive response to HIV prevention. By 1996 the State of Manipur introduced legislation for the first time in India to legalise harm reduction. It has subsequently been adopted throughout India as an important measure to contain the epidemic in settings where HIV transmission is associated with injecting drug use.

 

The SHALOM Project, originally supported by the Australian Agency for International Development, continues today with direct funding from the State government and grants from TEAR Australia.

 

In 2006 a HIV prevention and care program of this nature is not uncommon but 12-15 years earlier in a remote region of India it was a beacon of enlightened care and of compassionate Christian love.

 

This has been the pattern that Dr Langkham has taken with him into all subsequent phases of his work and ministry. In 1998 he established a community-based response for EHA meeting the health needs of injecting drug users in another remote and poor region of India along the Indo-Nepal border in the State of Bihar. This project attracted funding support from SIM.

 

In 2001 Dr Langkham joined his family in New Delhi to take up a senior role for EHA, one that continues to this day, namely as Director for HIV/AIDS services of EHA. This appointment has afforded the opportunity and responsibility to assist the development of HIV/AIDS services in many parts of the 12 states of India in which EHA supports projects and hospitals.

 

For the last two years Dr Langkham has made perhaps his most important contribution to date. As the Project Director of Project ORCHID on behalf of the India AIDS Initiative of the Bill and Melinda Gates Foundation he has overseen a response to HIV prevention among drug users on a scale not previously seen in Asia.

 

Project ORCHID executes a complex and comprehensive program of HIV prevention among injecting drug users, sex workers and their partners in the two most affected northeast states of India, Manipur and Nagaland. It is fitting that Dr Langkham’s current work (toward the end of his second decade in commitment to the control of the HIV/AIDS epidemic in India) should be in his homeland, the region where the epidemic has sadly made its greatest impact. With a hand picked team of dedicated Christian health workers drawn mostly from the northeast region he has managed to extend the same compassionate response to those individuals excluded by society (HIV infected drug users and sex workers) on a scale that has the opportunity of bringing the epidemic under control. Few have been able to expand and scale up a ‘boutique’ and model response to the scale required to work among more than 20,000 drug users and 6,000 sex workers in a rugged and remote terrain.

 

Even fewer have done something so commendable and yet maintained a true Christian humility and sense of calling. Dr Langkham would indeed be a worthy recipient of the ICMDA award.