Campaigning to halt HIV/AIDS

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.

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