Campaigning to halt HIV/AIDS

Sun, 20 Feb 2005, 00:00 WIB | Source: JP

Muninggar Sri Saraswati, The Jakarta Post, Jakarta

An HIV/AIDS activist was nearly arrested by the police two
years ago, when he provided sterile, disposable needles to an
injecting drug user (IDU).

The officer thought the activist was supporting the user's
habit. Luckily, the activist's colleague, who happened to be a
well-known doctor, managed to convince the policeman that the
needle distribution was part of their harm reduction program.

Most Indonesians may be unfamiliar with -- or have not heard
of -- this program. Policymakers and law enforcers are no
exception.

The harm reduction program is a scheme that aims to prevent
the spread of HIV/AIDS through shared needles. The program has 12
implementation measures, including informing IDUs with sufficient
knowledge on the possible transmission of HIV/AIDS through shared
needles and encouraging them to enter a rehabilitation center.

The most controversial aspect of the program is that it
provides IDUs with the alternatives of either methadone treatment
or sterile, disposable needles.

Methadone hydrochloride is a substitute drug that can be taken
orally instead of by injecting, used as a treatment to wean IDUs
off drugs.

Most law enforcers, however, consider it an attempt to protect
drug users and drug dealing, which explains the incident above.

The establishment of the National Network of Harm Reduction
Organizations (Jangkar) several years ago has played an important
role in addressing this issue and in supporting activists to
promote harm reduction in the country.

Jangkar secretary-general Sahrul Sjah said the network was set
up to reduce the spread of HIV/AIDS among IDUs in Indonesia.

According to the network, about 60 percent of all HIV/AIDS
cases contracted the virus through needle-sharing.

Currently, the network comprises 38 non-governmental
organizations focusing on drug use and HIV/AIDS at the
grassroots.

In Jakarta, Jangkar members include the University of Atmajaya
Information Kiosk, the University of Indonesia's Health Service
Center, Karisma Foundation and Stigma.

Outside Jakarta, the Bahtera Foundation in Bandung, Talenta
Foundation in Surabaya, Hatihati Foundation in Bali, Metamorfosa
and YKP2N in Makassar and Galatea in Medan are also members.

R. Suhendro Sugiharto, a Jangkar National Council member, told
The Jakarta Post that one of its missions was to provide legal
protection for outreach workers implementing the harm reduction
program. In addition, the network enabled HIV/AIDS activists to
share information, support each other and engage in heart-to-
heart discussions.

"Promoting harm reduction is not an easy task. We need to
share information to support each other," said Sugiharto, known
as Ebe among friends and colleagues.

Jangkar also produces publications and holds national meetings
annually to address the multifaceted issues regarding IDUs and
HIV/AIDS.

"And we provide support for members who plan to establish a
cooperation with law enforcers to introduce a harm reduction
program in their area," Ebe said.

Over the past few years, the rapid increase in the number of
IDUs and the spread of the virus due to needle-sharing has
reached alarming levels. As a result, the National Narcotics
Agency (BNN) and the Ministry of Health signed a memorandum of
understanding (MOU) in December 2003 to develop a program to
fight HIV/AIDS transmission among IDUs.

Under the MOU, IDUs who join a harm reduction program will be
exempt from anti-drug law enforcement measures.

Furthermore, a three-year pilot project involving local health
offices, police, research centers and NGOs was implemented late
last year in Jakarta and Bali.

While institutional and social stigmas remain about harm
reduction, the pilot projects are a benchmark in the national
drive to combat drug use and HIV/AIDS.

As regards the common misconception among law enforcers that
the program is a means to protect drug dealing or condone drug
use, Ebe explained that harm reduction was a means to prevent the
possible spread of HIV/AIDS among drugs users.

"There is also the supply reduction program and demand
reduction program, both of which are linked to law enforcement.
But the two would only achieve effective results if they are
combined with the harm reduction program," he said.