Tue, 27 Jul 2004

Activists differ over harm reduction program

Dewi Santoso Jakarta

A controversial harm reduction program that was introduced by the government on Friday has split opinion among activists over how effective it will be in containing the spread of HIV/AIDS.

The spokesman for the Working Group on HIV/AIDS at the University of Indonesia's School of Medicine, Zubairi Djoerban, expressed his optimism on Monday that the program would help reduce the spread of HIV/AIDS among injecting drug users.

"It will be one of the most effective measures to fight the spread of the virus among injecting drug users, provided that the government applies strict supervision," said Zubairi, who is also an AIDS expert.

According to 2003 data from the Ministry of Health, injecting drug users accounted for more than 80 percent of an estimated 80,000 people living with HIV/AIDS nationwide.

The ministry also estimated the number of injecting drug users in the country at between 124,000 and 196,000 at the end of 2002.

In an effort to curb the spread of HIV, the National Narcotics Body launched on Friday a pilot harm reduction program that will provide sterile disposable needles and disinfectants to injecting drug users, as well as methadone and buprenorphine for heroin users.

The pilot project, which will run for three years in Jakarta and Bali, will involve the police, local health offices, research centers and selected non-governmental organizations.

In Jakarta, the community outreach arms for the program are Atma Jaya University, which will run information and health kiosks in Duren Sawit, East Jakarta, and the University of Indonesia's Health Research Center, which will cover the Depok area.

The project team has several working groups that will be in charge of running counseling programs, providing health services and operating a needle-exchange program at harm reduction posts.

However, Pelita Ilmu Foundation (YPI) project manager Pungky Djoko said he doubted the program would be effective in combating the spread of HIV among injecting drug users.

"The program requires close monitoring because otherwise we won't know whether the clean disposable needles will be used by one person only or will be shared with other injecting drug users. And to monitor each (injecting drug user) is no picnic," Pungky told The Jakarta Post.

Zubairi agreed the harm reduction program would only work if it was conducted in small working groups of four or five with one mentor.

"A small working group will help the mentor get close to the injecting drug users and monitor them easier," he said.

A similar harm reduction program has been implemented by the YPI in Kampung Bali, Central Jakarta, since 2002. To date, there are 190 people registered with the program.

The registered drug users have to bring their used needles to the harm reduction post, where they can be exchanged for clean disposable needles.