Hopes high for harm reduction program to curb drug abuse

Hopes high for harm reduction program to curb drug abuse

Dewi Santoso, Jakarta

Andi, 24, cannot stop injecting drugs -- even though he tested
positive for HIV three years ago.

Although he now regrets the possibility that his days are
numbered due to the habit that has been an integral part of his
life since he was 18, Andi expresses the hope he will not
transmit the virus to others.

He is one of around 190 injecting drug users (IDUs) who attend
a harm reduction program run by the Pelita Ilmu Foundation (YPI)
in Kampung Bali, Tanah Abang district, Central Jakarta. Drug
abuse has been widespread for years in Kampung Bali.

The controversial harm reduction program aims to discourage
the sharing of needles among IDUs, or even stop drug abuse
altogether.

Andi described the program as "helpful" and "hopeful".

"Before I joined the program, I used to inject heroin into my
veins six to eight times per day. Now I've managed to reduce it
to three times a day," said Andi, who helps YPI as a program
volunteer.

During the program, he was taught about the need to use clean,
disposable needles and refrain from sharing used needles with
fellow IDUs.

Andi said participants of the program were told to bleach
needles after using them, in order to keep them clean. Often,
because of too much bleaching, the needles became useless for
injecting anymore.

"Yet, we try our best to make use of what we have as we are
already aware of the dangers of sharing needles and don't want
others to contract HIV/AIDS," said Andi.

Another IDU, Heru, who also lives in Kampung Bali, shared
Andi's opinion.

"The program teaches me how to clean my used needles using
bleach so as to prevent myself from contracting or spreading the
virus," said the 25-year-old, who has been injecting heroin for
six years.

He tested negative for HIV recently.

Since joining the program two years ago, he said he had
managed to reduce his heroin injecting frequency to four times
per day, from eight previously.

YPI ran the harm reduction program secretly at its inception
in 2002, as at that time it was considered illegal.

The Ministry of Health estimates the number of IDUs at 124,000
to 169,000, with more than one-third HIV-positive.

Due to the rapid increase in the number of IDUs and the spread
of the virus due to needle sharing, the National Narcotics Agency
(BNN) and the Ministry of Health signed a memorandum of
understanding (MOU) on the program to fight HIV/AIDS among IDUs
in December 2003. Under the MOU, IDUs who join the harm reduction
program will be exempted from police measures against drug abuse.

Less than two weeks ago, the BNN officially launched the harm
reduction program in a pilot project scheduled to run for three
years in Jakarta and Bali. The program will involve local
authorities, including health offices, the police, research
centers and selected, non-governmental organizations (NGOs).

The program aims to discourage the sharing of contaminated
drug equipment by providing sterile, disposable needles and
disinfectants so as to reduce the likelihood of IDUs contracting
and spreading HIV/AIDS.

Every Monday and Thursday an IDU will be given two sterile
needles, along with disinfectants.

The program has sparked controversy, as many people consider
that the provision of clean, disposable needles to IDUs is
tantamount to government support of drug abuse.

Baby Jim Aditya of the NGO Human Participation (Partisan),
which is concerned with HIV/AIDS activism, said the program would
be effective if the government maintained strict supervision of
recipients, otherwise IDUs would continue to share needles.

"If possible, we should learn from the Netherlands, which has
introduced a 'shooting gallery', where IDUs can exchange used
needles for new ones. The new needles are dumped after use in the
gallery," Baby Jim said on the sidelines of a commemoration here
of World Antidrug Day on Saturday.