Tue, 13 Jul 2004

Govt's AIDS effort deficient: Activists

Dewi Santoso, Jakarta

While the government has demonstrated its will to fight the spread of HIV/AIDS in the country, it has failed to provide adequate access to medical care and treatment facilities, say people living with HIV/AIDS (PLWHA) and activists.

Pelita Ilmu Foundation (YPI) program manager Pungky Djoko said on Monday the greatest difficulties faced by PLWHA was access to medical care and treatment facilities, because of inadequate equipment.

"We do have a voluntary counseling and testing (VCT) center here in Kampung Bali, where people can get blood tests for the virus. But after they receive their results, there isn't any follow-up, and that's what we actually need," he said.

He said the public were generally knowledgeable about HIV/AIDS, but they were not aware of the necessary measures to take if they were diagnosed HIV-positive.

A 24-year-old who contracted the virus through sharing needles agreed with Pungky, saying people needed follow-up care and counseling on living with HIV/AIDS.

Ministry of Health data shows that 3,924 people across the country had been diagnosed with HIV/AIDS from 1987 to 2003, of which 2,685 were HIV-positive. Of the remaining 1,239 who had developed AIDS, 428 have died. The ministry estimates between 80,000 and 130,000 Indonesians live with HIV/AIDS.

Meanwhile, a country report issued by the Joint United Nations Program on HIV/AIDS (UNAIDS) shows the number of PLWHA around the world continues to grow, from 35 million in 2001 to 38 million in 2003.

UN Secretary-General Kofi Annan chided world leaders on Sunday for not doing enough to contain the epidemic.

"We need leaders everywhere to demonstrate that speaking up about AIDS is a point of pride, not a source of shame," Annan said at the ongoing International AIDS Conference in Bangkok.

Another PLWHA said not only should the government provide follow-up care, it should also provide advanced laboratory test equipment, particularly to facilitate the CD4 test.

Pungky agreed, adding that not many hospitals could provide the test.

CD4 cells are a type of lymphocyte that coordinate the immune system's response to certain microorganisms, such as HIV, which can infect and kill white blood cells. The CD4 test measures the number of CD4 cells per cubic millimeter of blood.

A normal count in a healthy, HIV-negative adult can vary, but is usually between 500 and 1,500 cells/c mm. A CD4-cell count of 200 cells/c mm and below generally reflects a vulnerability to opportunistic infections.

"Another obstacle faced by people living with HIV/AIDS is the high cost of antiretroviral (ARV) drugs. The government promised to subsidize Rp 200,000 (US$21.27) for a monthly dose of ARV. But the subsidy has not been disbursed to date," Pungky told The Jakarta Post.

Last year, the government launched the production of five generic ARV drugs by pharmaceutical giant PT Kimia Farma, to be sold at about Rp 400,000 per monthly dose exclusive of the planned subsidy.