A present danger

A present danger

Up to September, 449 people in Indonesia either had the still
incurable Acquired Immune Deficiency Syndrome (AIDS), or had
tested positive for Human Immunodeficiency Virus (HIV), which
causes the syndrome, and 66 of them had died. This, it must be
noted, is according to the latest accounts made public by the
Ministry of Health. Non-governmental and international
organizations put their estimates much higher. According to the
World Health Organization, as many as 50,000 Indonesians might
already be infected with HIV.

Indonesians have long understood that the official figures are
most likely on the low side, presumably because only reported
cases are counted and because infection with HIV is usually not
detected until after AIDS symptoms occur. Now a radically
different estimate has surfaced, which hopefully will jolt
Indonesians out their lethargic approach to preventing the spread
of HIV.

According to the Center for Health Research, which is run by
the University of Indonesia, between 12,000 and 31,000 people in
this country are already dying each year from AIDS. As the
center's director, Meiwita B. Iskandar, explained, the figures
are far higher that those officially acknowledged by the
government because Indonesia lacks an effective system for
monitoring the actual number of HIV and AIDS cases in this
country and so only the reported cases are recognized.

But even allowing for such difficulties, we believe most
people will agree that the disparity between the two estimates --
that of the Ministry of Health and that of the University of
Indonesia's Center for Health Research -- really stuns the mind.
The research center's lowest estimate of the annual death figure,
for example, is almost two hundred times the total number of
deaths recorded by the ministry. And if between 12,000 and 31,000
people in this country die of AIDS each year, certainly the
number of people who at present either have AIDS or are HIV-
positive must be dramatically greater than the 449 recorded by
the health ministry as of September.

We are aware that it is not easy to obtain accurate nationwide
statistics about anything in this country. Nevertheless, the huge
gap that exists between the AIDS and HIV figures as mentioned
above somehow needs accounting for. One might question the
accuracy of the Center of Health Research's figures, but surely
not the reputation of the University of Indonesia with which the
center is associated. Thus the figures which it has released
cannot simply be discarded as a product of sensationalism.

The estimate of the Center for Health Research -- or rather
the discrepancy between its estimate and that previously made
public by the government -- is shocking in more ways than one. On
the one hand the center's figures suggest that AIDS is already a
clear and present danger in Indonesia. On the other hand they
could raise the suspicion of a cover-up concerning the real
magnitude of the AIDS hazard in this country.

While it is true that an alarmist approach to the problem
would only aggravate the situation, trying to keep the public
calm by leaving people ignorant of the true magnitude of the
threat of AIDS would be criminal. A helpful first step towards
attacking the problem would be to abandon our present seemingly
easygoing approach toward AIDS and to develop a more aggressive
line of attack in preventing HIV infection.

A deeper and wider awareness of the problem must be cultivated
among the public. Moral and religious education, as suggested by
many, would decidedly help, but the more pragmatic course of
educating the public, especially sex workers and those who are
likely to come into contact with them, in the practice of safe
sex must not be overlooked.