AusAID and the Indonesian Government Cooperate on HIV/AIDS prevention

The problem of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) is no longer limited to certain groups in society. The threat of this condition, which attacks and breaks down the body's immune system, has spread worldwide, and all nations are currently held accountable to help overcome the problem.

One international cooperation that has been established is the HIV/AIDS and Sexually Transmitted Diseases (STDs) Prevention and Elimination project, which is a bilateral project between the Government of Indonesia and the Government of Australia.

This project, with more than AUS$20 million in funding, is intended to assist the Indonesian Government in decreasing the rate of sexually transmitted diseases, including HIV/AIDS, in Indonesia. As a pilot project, three provinces have been selected to represent the Indonesian people's various cultures and beliefs. They are: Bali, Nusa Tenggara Timur (NTT) and South Sulawesi.

Assistance from the Government of Australia -- through its formal aid institution, the Australian Agency for International Development (AusAID) -- dates back 40 years. During that time, the Australian Government has been involved in various projects to help people in poverty and raise community living standards.

The Australian Government has extended more assistance to Indonesia compared with other Southeast Asian countries. In the period from 1989 through 1999, for example, the total assistance will reach A$127 million, including A$50 million for humanitarian relief due to a long drought and an economic crisis that has hit Indonesia.

For the HIV/AIDS prevention project, the allocated fund is A$19.6 million. It is a joint fund provided by the Australian Government (A$17.6 million) and the Indonesian Government (A$2 million). This five-year project started in September 1995 and will end in September 2000.

As a result of the economic crisis, the HIV/AIDS problem has become more critical. More and more people are vulnerable to HIV infection. As an illustration, there are currently 770 AIDS cases recorded in Indonesia. However, the real figure (unrecorded) might well reach up to 77,000, 100 times more than the official number. This figure will increase rapidly if preventive actions are not taken.

Fortunately, there is a serious commitment between government and non-governmental organizations in Indonesia to work together to eliminate the danger of HIV/AIDS.

AusAID has established the HIV/AIDS prevention project in cooperation with the Office of the Coordinating Minister for People's Welfare and Poverty Eradication. This cooperation is extremely close and the project team office is located in the office of the ministry.

The Australian Team Leader, Dr. David B. Elkins, explained that the reason for the cooperation with the Coordinating Minister for People's Welfare and Poverty Eradication was due to the fact that the ministry is in charge of coordinating the departments related to poverty-alleviation issues, including the HIV/AIDS prevention issue.

The increase in poverty which people are suffering from this year can have a direct impact on increasing the transmission of HIV/AIDS. During the current economic crisis, the impact of AIDS among low-income groups is especially devastating. Poorer families have no margin to absorb the cost of health care, or the loss of earnings. The cost of the HIV epidemic will fall most heavily on the poor, further entrenching their poverty and amplifying existing socioeconomic inequity.

"In order to strengthen this program, coordination with the related ministries is urgently required. The National AIDS Commission is also located in the ministry's office and they are our key partner in HIV/AIDS prevention and care programs," Elkins added.

The Office of the Coordinating Minister for People's Welfare and Poverty Eradication is responsible for coordinating all activities of all related departments. However, without support from various sectors, it would not be possible to implement such a project. As explained by Elkins, there are a number of sectors that are involved in the bilateral project.

At the central level, support is provided by six related departments: the Ministry of Health, the Ministry of Social Services, the National Family Planning Coordinating Agency, the Ministry of Religion, the Ministry of Education and Culture and the Ministry of Manpower. In addition, at the regional level, support is provided by local governments of the three provinces selected for the pilot project.

AusAID is also cooperating with 42 non-governmental organizations that are concerned with the HIV/AIDS issue. Non- governmental organizations provide a vital link to individuals and communities at risk from HIV/AIDS and STDs. Their active participation in HIV/AIDS prevention has been a cornerstone to successfully implementing the Indonesian National HIV/AIDS Strategy.

Most of the activities conducted in this HIV/AIDS and STD project support institutional strengthening of national and provincial HIV/AIDS commissions and capacity building of non- governmental agencies. Prevention activities focusing on providing information, education and communication to the general public as well as to high-risk groups is a vital component. Although AIDS is a popular issue, there is still a great deal to be done to ensure that people know the basic facts about HIV transmission and, more importantly, assess their own personal behavior and decide if they are at risk of infection.

Other activities of the project include prevention, social research, blood testing, counseling and other STD treatment. "We also build the capacity of the non-governmental organizations to make them self-reliant in skills, technical knowledge, management and fund raising," Elkins pointed out.

Based on a decree by the Office of the Coordinating Minister for People's Welfare and Poverty Eradication, three non- governmental organization advisory groups have been established in Bali, NTT and South Sulawesi. These advisory groups evaluate the feasibility of proposals from participating non-governmental organizations and also offer suggestions on the funding.

Through this process, the 42 non-governmental organizations from the three provinces have conducted more than 100 activities which directly relate to the national treatment and prevention strategy for HIV/AIDS and sexually transmitted diseases. Activities conducted in the three provinces are expected to be models for HIV/AIDS prevention programs in other regions in Indonesia in the future.