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.