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Hope abounds for new RI leaders to take firm stance on HIV/AIDS
In the history of public health, HIV/AIDS has been exceptional -- it has had widespread and long-lasting demographic, social, economic and political impact incomparable to any other health issue
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em>In the history of public health, HIV/AIDS has been exceptional -- it has had widespread and long-lasting demographic, social, economic and political impact incomparable to any other health issue.Under a scholarship from the International AIDS Society (IAS) and with support from the United Nations Joint Program on AIDS (UNAIDS), The Jakarta Post's Rita A. Widiadana attended the 20th International AIDS Conference in Melbourne, Australia, to learn more about global progress in HIV/AIDS responses, including in Indonesia. The following are reports from the five-day conference.
The recent International AIDS conference, organized by the Geneva-based International AIDS Society and its partners including UNAIDS and the WHO, attracted 13,000 delegate members from around the world and ended with a global chorus of international figures, including former US president Bill Clinton and humanitarian activist and musician Bob Geldof, scientists and civil society groups hoping to end the AIDS epidemic by the year 2030.
Such a task will not be easy, however, especially for developing nations like Indonesia, which is facing tremendous public health and social problems.
During the five-day conference, Indonesia was in the global spotlight for all the wrong reasons, being named one of the few countries where HIV infection has significantly increased in recent years.
HIV/AIDS constitutes a major challenge for Indonesia's new leaders, as it is more than a health issue. For Indonesia, the scale of the societal and economic impact of HIV/AIDS could be disastrous, as the disease can reverse a country's annual economic growth by 1 or 2 percent if it is not properly managed.
Economic wealth in the form of gross national product (GNP) could drop in some areas by as much as 40 percent by 2020. Translated to a country like Malaysia, Thailand or Indonesia, this is a sum worth billions of dollars, according to a report from an Australian donor agency.
'While new infections continue to decrease globally, we unfortunately are seeing a very different pattern in several countries in our region, with increasing number of infections in Indonesia, Pakistan and the Philippines in 2013,' explained Sharon Lewin, co-chair of the conference and one of the International AIDS Society's (IAS) team of global researchers.
UNAIDS data show there were 35 million people living with HIV worldwide in 2013. Geographically, the majority of people living with HIV have been found in 20 countries, predominantly in sub-Saharan Africa but also in larger middle-income countries such as China, Brazil, India, Russia, Thailand and Indonesia.
In the Asia and Pacific region, there were 4.8 million people living with HIV, including 350,000 new HIV infections in the region in 2013.
In Indonesia, where the first HIV/AIDS case was discovered in Bali in l987, the number of people living with HIV was estimated at 640,000 by UNAIDS data in 2013.
Demographically, in every region in the world, HIV/AIDS shows high prevalence among certain groups, including men having sex with men (MSM), people who inject drugs (PWID), sex workers and their clients, transgender people, prisoners, migrants, pregnant women and their babies.
Similarly, in Indonesia, a high incidence of HIV infection among men having sex with men is found in Jakarta (15 to 17 percent) and other big cities. The incidence among intravenous drug users (IDU) is 36.4 percent.
In Jayawijaya, Papua, HIV rates among female sex workers are as high as 25 percent, and 18 percent for male sex workers. Around 30.8 percent of waria (transgenders) people in Jakarta are HIV positive.
Steve Kraus, UNAIDS Asia and Pacific regional director, told The Jakarta Post: 'The newly elected leaders of Indonesia must be briefed on the real situation of HIV/AIDS in Indonesia, its current program and the mounting challenges Indonesia is now facing.'
Michel Sidibé, UNAIDS executive director, told the Post that Indonesia had been implementing beneficial and innovative programs in scaling up testing and treatment for people living with HIV in the last two years.
'The country has optimized all resources ' in the fields of policy making, funding, investment and human resources ' to give opportunities for people living with HIV to get health access, which has resulted in the identification of new HIV infections,' Sidibé added.
'Indonesia is taking dramatic steps to slow the rate of new infections. More recent initiatives aimed at increasing access to testing and treatment are leading the way,' added Kraus.
Under Health Minister Nafsiah Mboi, Indonesia has been taking progressive and bold action by greatly expanding HIV testing, counseling and treatment services.
Early initiation of antiretroviral treatment (ART) can now be offered to people living with HIV including pregnant women in 10 districts across the country's 33 provinces. By the end of 2014, the program will be expanded to 72 districts.
Indonesia also plans to become one of several countries in the region to offer universal care by 2014, with HIV treatment included in health coverage.
'Expanding HIV treatment is part of the Indonesian government's drive to meet the Millennium Development Goals and stamp out AIDS,' Mboi said.
Given Indonesia's size and diffusion, a central challenge now will be ensuring that the ministry's directives are implemented at local level.
HIV/AIDS activists are also hopeful that the new government will listen to them and work alongside them.
Vinolia Wakijo, a prominent defender of transgender people and sex workers in Yogyakarta, said that implementing the AIDS response without involving affected groups would be almost impossible.
'Bu Naf [Nafsiah Mboi] is a minister who has an open mind and heart as she has invited [transgender people and sex workers], as well as MSM and people injecting drugs, to be part of the solution,' Vinolia said.
Tono Permana, coordinator of a national network for men who have sex with men and transgender people, applauded the program.
Dede Oetomo, founder of Gaya Nusantara, a leading gay rights advocacy group, said he was hoping that president-elect Joko 'Jokowi' Widodo would have an open mind and an innovative program.
'HIV is more than just a public health threat. It encompasses deep social, cultural and religious stigma and discrimination against the affected people. Jokowi seems willing to listen to people's needs,' Dede said.
