Business as usual won't stop AIDS
Business as usual won't stop AIDS
Warief Djajanto Basorie, Jakarta
Indonesia estimates it has between 90,000 and 130,000 people
living with HIV-AIDS. The alarming matter is that as much as 85
percent of them are in their productive years, aged from 15 to
45. The implication is if the numbers are left to grow, the loss
of a future working generation could hurt the nation.
Indonesia has modestly aimed for 5,000 people with access to
antiretroviral treatment by 2004 and 10,000 by 2005. ARV
treatment is a combination of at least three drugs that slows HIV
progression and helps to prolong life.
The total number of patients receiving ARV by the end of 2004,
however, was 1,553, according to one government count. This
figure is based on data compiled from 25 hospitals nationwide the
health ministry assigned since July 2004 to accept and treat for
free low-income people with HIV.
The actual reach is in fact higher as services outside the 25
hospitals also provide therapy. These service providers include
outreach NGOs like the Jakarta-based Yayasan Pelita Ilmu that
works in voluntary counseling and testing as well as in care and
treatment.
Indonesia's country report of January 2005 on its follow up to
a 2001 UN General Assembly Special Session on HIV/AIDS (UNGASS)
estimated the total number of people who had received treatment
at the end of 2004 was 3,000, still well short of the 5,000
target.
Not all of the designated hospitals have adequate medical,
nursing and counseling capacity. The voluntary counseling and
testing clinics in the hospitals often do not yet properly
function.
Detection of cases is also another problem. HIV-positive
people may not be aware they are infected. Those that are aware
may be reluctant to be tested and treated for fear of
discrimination.
Health authorities will have to scale up the means of the 25
hospitals and put in place a case detection mechanism with NGO
outreach help that protects HIV positive people from
discrimination.
Indonesia is just one country in Asia and the Pacific with
much work to do on AIDS. The current overall picture of the
epidemic in the region that houses half of humanity is daunting
if not grim.
Some highly-populated countries like China, India, and
Indonesia have not reached a generalized epidemic where 1
percent or more of its people are already HIV infected. However
these countries do have at-risk groups that can infect the public
at large.
The prospect of stopping the spread of HIV infection becomes
dim when nations take a business-as-usual approach.
"If it's business is usual, we'll miss the sixth goal of the
MDGs (Millennium Development Goals) ," UNAIDS Asia-Pacific
director Prasada Rao says. The sixth goal of the eight UN-
initiated goals is to halt and begin to reverse the spread of
HIV/AIDS by 2015.
The call then is to scale up the response to AIDS so that the
sixth goal can be reached. Increasing the response according to a
fixed ratio includes more effort in prevention, care and
treatment.
Prevention focuses on promoting behavioral changes, education
for individuals in vulnerable groups on safer sex and use of
sterile needles. Initiatives to that end include a 100 percent
condom use program in brothels and a needle and syringe exchange
for injecting drug users.
The WHO and UNAIDS launched care and treatment programs for
three million people already infected with HIV in December 2003
in the region.
What about vaccines? After 20 years of research none are
viable yet. We all need to work harder to fight this disease.
The writer managed a 12-month workshop on AIDS for journalists
in 2004 at the Jakarta-based Dr. Soetomo Press Institute, LPDS.
He can be reached at wariefdj@yahoo.com.