The Ministry of Health (Kemenkes) has stated that equal and fair\nhealthcare services are essential to ensure proper treatment for\nvulnerable groups with tuberculosis (TB) and\/or HIV.<\/p>\n
\"These vulnerable groups face structural barriers, stigma, and even\nviolence, which make access to healthcare difficult or dangerous,\" said\nImran Pambudi, Director of Health Services for Vulnerable Groups, in\nJakarta on Sunday.<\/p>\n
He explained that the success of antiretroviral therapy has extended\nlife expectancy, resulting in a growing number of people with HIV\n(PLHIV) entering old age. In Indonesia, approximately 7.7 per cent of\nPLHIV are over 50 years old, or around 39,000 people out of a total of\nmore than 500,000.<\/p>\n
\"This figure is expected to continue rising until 2030. However, our\nhealth services are being continuously prepared to address and face the\ncomplexity of comorbidities in the elderly, such as cardiometabolic\ndiseases, cognitive impairment, osteoporosis, and complex drug\ninteractions,\" he said.<\/p>\n
He noted that elderly people with HIV currently often have to move\nfrom one clinic to another to receive ART, diabetes management,\nhypertension treatment, and cardiovascular examinations. According to\nImran, this fragmentation of services risks increasing the cost and time\nburden, as well as raising the risk of patients discontinuing\ntreatment.<\/p>\n
Furthermore, he said, TB in the elderly is a substantial and growing\nburden. A global analysis shows that in 2023, people aged 65 and over\naccounted for 21 per cent of all TB cases and 23 per cent of TB\ndeaths.<\/p>\n
\"The number of cases in this group has increased since 2000, a trend\noccurring even though overall TB incidence has declined in some regions.\nTB in the elderly also demands special attention,\" he said. He mentioned\nthat the symptoms are often atypical, making them easily mistaken for\nsigns of ageing or other chronic diseases.<\/p>\n
This condition can potentially lead to delayed diagnosis and\ncontinued transmission. Moreover, nearly 40 per cent of elderly people\nin Indonesia live in three-generation households, meaning they can\nbecome a primary source of transmission for children in the home. Imran\nadded that the elderly are more vulnerable to the side effects of TB\ndrugs and require intensive monitoring.<\/p>\n
In Indonesia, active detection strategies at elderly integrated\nhealth posts (posyandu lansia), nursing homes, and primary care services\nmust be strengthened, accompanied by training for health workers to\nrecognise TB in old age and manage polypharmacy safely.<\/p>\n
He said community-based services have proven more effective at\nbuilding trust, increasing case finding, and improving treatment\nretention. Therefore, the government and partners must acknowledge the\nvital role of communities, provide sustainable funding, and ensure a\nstable supply chain and data.<\/p>\n
Furthermore, he said, health facilities, educational materials, and\nreferral systems must be inclusive for persons with disabilities. This\nmeans ensuring physical access to clinics, providing information in\ndisability-friendly formats, and training health workers to communicate\nwith empathy.<\/p>\n
Consequently, he said, service integration is key. HIV and TB clinics\nmust be connected with mental health services, non-communicable disease\nmanagement, social protection, and rehabilitation. An integrated service\nmodel can reduce the patient burden while improving clinical\noutcomes.<\/p>\n
At the policy level, he said, financing must be directed to support\npatient-centred, community-led service models. Quality-of-life\nindicators, Imran said, such as retention in care, viral suppression in\nthe elderly, reduction in gender-based violence, and access to services\nfor persons with disabilities, must become the main benchmarks.<\/p>\n
According to him, Indonesia possesses strong social capital and\ncommunity networks. The challenge is how to transform this capital into\npolicies and practices that reach those who are most vulnerable.<\/p>\n
\"If we place people at the centre of the HIV and TB response, we not\nonly lower case numbers but also restore dignity, health, and life\nexpectancy for every person, without exception,\" he said.<\/p>", "url": "https:\/\/jawawa.id\/newsitem\/health-ministry-equitable-access-protects-vulnerable-groups-with-tb-hiv-1783230742", "image": "" }, "sponsor": "Okusi Associates", "sponsor_url": "https:\/\/okusiassociates.com" }