Cheaper AIDS drugs not the full story

Cheaper AIDS drugs not the full story

While your editorial on AIDS in the July 15 edition of The
Jakarta Post was both accurate and timely I wonder if it will
have the desired effect, ie. mobilizing the authorities to
quickly implement the right public health measures in order to
stem the tide of infection and prevent a catastrophe.

Much of the recent discourse in Indonesia has centered around
the government's initiatives to procure cheaper generic drugs for
people with HIV, and no doubt new treatments such as highly
active antiretroviral therapy (HAART) have improved morbidity and
reduced mortality from AIDS. However HAART should only be
administered under the expert supervision of a specialist
physician who can recognize when the virus is no longer
responding to the medicine or if the patient is not complying
with the treatment regime. Without this HAART may actually make
the problem worse by increasing the chance of drug resistant
strains that become more difficult to treat in the future.

AIDS patients must also have access to sensitive tests to
monitor their HIV level during the course of treatment. Despite
becoming standard practice in the management of this disease such
"viral load" tests are rarely performed in Indonesia due to their
additional cost and the scarcity of specialist laboratories who
have the expertise to do them.

HAART can be most effective in preventing transmission of HIV
from an infected mother to her unborn child. Therefore a
nationwide program to identify HIV-positive women during
pregnancy and to implement a treatment protocol to minimize
mother-to-child transmission should be an urgent priority.

AIDS education remains an underutilized instrument of public
health policy in many countries despite its usefulness in
containing the spread of HIV. It would be good to see some of the
funds recently earmarked by the Indonesian government for
fighting AIDS being dedicated to raising public awareness of
high-risk behaviors while at the same time promoting simple
preventative measures, such as condom use, to contain its spread.

DAVID BEINS, Jakarta