Govt ponders controversial AIDS program

Govt ponders controversial AIDS program

Dewi Santoso, The Jakarta Post, Jakarta

The government is considering a nationwide HIV/AIDS harm
reduction program that will provide injecting drug users (IDU)
with clean disposable needles and methadone treatment.

Coordinating Minister for People's Welfare Jusuf Kalla said on
Thursday the program was an initiative to break the transmission
chain of HIV/AIDS among IDUs.

The program will commence as soon as the National AIDS
Commission (KPA) and the National Narcotics Agency (BNN) sign a
Memorandum of Understanding (MOU) on Monday.

Data from the Ministry of Health reveals that half of the
between 124,000 and 169,000 IDUs are HIV positive. The official
number of people living with HIV/AIDS in the country is estimated
at between 80,000 and 130,000.

Kalla admitted the program would spark controversy, including
opposition from the same people and groups who so strongly
opposed promoting the use of condoms for prophylactic purposes.

"The government will promote the use of condoms not to endorse
promiscuity, but to prevent HIV/AIDS from spreading. Through the
new MOU the government does not intend to legalize the use of
narcotics or other addictive drugs, but to help prevent IDUs from
contracting the virus," said Kalla, who chairs the KPA.

BNN director Comr. Gen. Togar Sianipar said the program might
be in violation of Law No. 22/1997 on narcotics and Law No.
5/1997 on psychotropic substances.

Article 80 of Law No. 22/1997 says that the importation,
exportation, sale, purchase or distribution of narcotics is
subject to between seven and 20 years in jail and a fine of up to
Rp 1 billion (US$117,647).

Article 59 of Law No 5/1997 states that anyone using,
producing, importing or distributing psychotropic substances is
liable to a prison term of between four and 20 years and a fine
of up to Rp 5 billion.

"But we will find some way around this so that we can help
prevent IDUs from contracting and spreading HIV/AIDS," said
Togar. He said that should the government implement the program,
it would need to be conducted under strict supervision.

The government has allocated Rp 120 billion to execute the
national strategy against HIV/AIDS 2003-2007, which will include
campaigns, education, seminars and harm reduction programs.
Between Rp 12 billion and Rp 15 billion will be allocated to the
provision of antiretroviral treatment.

By comparison, the government has allocated Rp 5.85 trillion
on the free healthcare program for the poor.

According to Samsuridjal Djauzi, the chairman of the AIDS
Special Discussion Group (PokDisus AIDS), a non-governmental
organization, the harm reduction program was not intended to
legalize the use of addictive drugs, but rather to prevent IDUs
from spreading HIV/AIDS and help them overcome their addictions.

"The program offers methadone treatment, which allows IDUs to
take tablets instead of injecting, and clean disposable needles
for IDUs who refuse to take the oral treatment," Samsuridjal, who
is also a medical practitioner, told The Jakarta Post.

Hospitals for the rehabilitation of drug addicts, in
cooperation with the World Health Organization (WHO), have been
running small-scale methadone treatment programs for
approximately two years. The disposable needles program started
around three years ago in Kampung Bali in Central Jakarta and
produced a decrease in the number of IDUs, Samsuridjal said.

Only a few countries have implemented the program as it is
still controversial, even in the United States and Australia. The
Netherlands is among the program's success stories. India and
Thailand have also participated in the program on a limited
scale.

"As a health worker, I support any option that can lessen and
prevent the virus from spreading as long as it is implemented
voluntarily," Samsuridjal said.