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.