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