Guest Column with Michelle Kermode

January 12 / 78

Dr Michelle Kermode is a Senior Research Fellow who joined the Nossal Institute for Global Health (formerly the Australian International Health Institute) in 2004. She is the Technical Director of the Northeast India Knowledge Network, and is based in India for six months a year.

The states of Manipur and Nagaland are located in Northeast India, a region characterised by longstanding civil insurgent movements, a strong military presence, religious conservatism, poor infrastructure and unemployment. Bandhs (strikes) and curfews frequently restrict civilian movement, commercial activity and the delivery of public programs including education and health. Many people live in isolated hilly areas with long travel times to the nearest town due to both distance and poor road conditions.

Another major problem in these two states is a longstanding HIV epidemic. The main driver of this epidemic has been unsafe injecting drug use, but the importance of sexual transmission as a cause is being increasingly recognized. For almost two decades government and non-government organizations have been mounting a response to the epidemic with support from international donors, with the result that some gains have been made, but much remains to be done.

The Northeast India Knowledge Network is a four-year project awarded to the Nossal Institute for Global Health and funded by the Bill & Melinda Gates Foundation. The goal of the Knowledge Network is to document the lessons learned from implementation of HIV prevention interventions, describe HIV transmission dynamics, and assess the impact of the HIV prevention response in the states of Manipur and Nagaland. The Knowledge Network team consists of staff from Melbourne who travel frequently to India, as well as local Indian staff. We work in close partnership with local institutes, government agencies, and non-government organizations, which involves frequent formal and informal consultation and dissemination meetings with our partners and affected communities to ensure that the Knowledge Network’s program of work supports and complements local needs and priorities.

To date we have documented the history of the HIV epidemic in Manipur and Nagaland, and are creating a series of monographs documenting the more innovative initiatives of one of our partner organizations (Project ORCHID) including the nurse-led management of sexually transmitted infections, and a program for distribution of needles, syringes and condoms to drug users in geographically remote communities. Our analytical work has included analysis of program data related to the provision of drug substitution therapy to injecting drug users, the health service needs of female drug and alcohol users, and the effectiveness of Project ORCHID’s HIV prevention interventions.

Working on the Knowledge Network grant is complex, intense and challenging, but India is a wonderful country to work in, and the Knowledge Network team members are all a pleasure to work with. For more information about the work of the Northeast India Knowledge Network see 


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