Police see greater role in halting spread of drugs, HIV

Damar Harsanto, The Jakarta Post, Jakarta

In Indonesia, people found in possession of illicit drugs will be given two "choices": being charged with abusing drugs or being charged with drug dealing. There is no in-between -- that is what the law says.

Both Law No. 5/1997 on psychotropic substances and Law No. 22/1997 on narcotics clearly outlaw the use and trade of psychotropic substances and narcotics for any purpose other than scientific and medical applications.

The laws, however, fail to regulate whether these substances could be used in rehabilitating drug users.

The problem arises because a user must gradually reduce their dependence on drugs through a controlled and closely monitored rehabilitation program.

Furthermore, amid needle scarcity, many drug users prefer to share unsterilized syringes making them exposed to various infections caused by needle-borne virus transmission, like Hepatitis C virus and the Human Immunodeficiency Virus (HIV).

The high-risk behavior of injecting drug users (IDUs) is evident in the Ministry of Health's 2003 national estimate, which shows an HIV-positive diagnostic prevalence of about 50 percent -- in 2002, the rate was 27 percent -- among the 124,000 to 196,000 IDUs recorded in the country.

This figure does not include people who may have contracted the virus through sexual intercourse and blood transfusions.

"We cannot let such a serious problem go on untouched. That's why we need an integrated and comprehensive measure to tackle the problem," director of the National Narcotics Agency (BNN) Comr. Gen. Makbul Padmanagara told participants in the National Harm Reduction Conference, which ran from Feb. 14 through Feb. 17.

Makbul said that such measures ranged from halting the soaring number of drug users, significantly reducing the number of IDUs, providing rehabilitation and care for drug users; curbing HIV transmission among IDUs and staving off HIV transmission to the general population.

Toward this end, the BNN signed a Memorandum of Understanding (MOU) with the National AIDS Commission (KPA) in 2003 to lay down a political and institutional foundation for a harm reduction program across the country; the two government bodies have followed up on the agreement with the launch of two pilot projects on needle and syringe exchange in Bali and Jakarta.

However, the BNN and the National Police have been cautious about adopting the harm reduction program, which includes -- apart from the needle and syringe exchange program -- the use of methadone hydrochloride as a substitute drug.

"The needle and syringe exchange program should only be used as part of the broader approach to reach out to injecting drug users. It must be conducted within a limited time frame," Makbul said.

He added that stricter requirements must also be imposed on parties involved in the program, including outreach workers and police officers.

"Police are yet to recommend that the program be adopted nationwide, since the laws we have do not provide detailed guidelines for us. Should we want to adopt it, we must first revise the prevailing laws," said director of the National Police Narcotics Directorate, Sr. Comr. Yotje Mende.

Yotje said the use of methadone as a drug substitute, for instance, violated the law on psychotropic substances, which also outlaws the use of methadone.

Former BNN director (ret) Comr. Gen. Togar Sianipar reinforced Yotje's statement, saying the police had to be very selective and careful in adopting such a program, owing to a poor supervision and monitoring system.

"I have learned from the experience of several other countries that have adopted the program that it failed to help people kick their drug habit. Besides, we had a bad experience when we discovered that outreach workers of an non-governmental organization in Surabaya also used drugs themselves," Togar said.

He emphasized that implementing the program without improving the monitoring and supervision system would do more harm than good.

"In addition, we need to bring our police officers' knowledge about drug-related issues up to date by including drug issues in the police curricula. Of course, we don't want our police, out of ignorance, to turn into drug users or dealers and therefore become part of the problem themselves," he asserted.

The National Police could learn from the experience of the Calcutta police force in India, members of which have been receiving training about drug-related issues regularly, about three to four times a year.

"Since about five to six years ago, we have required police officers to take training and in-service courses in small batches so that they understand the real problem of drugs and how injecting drug users could lead to an HIV epidemic," Calcutta Police Dep. Comr. Soumen Mitra, who was a keynote speaker of the conference, told The Jakarta Post.

Mitra added that police officers also received additional training prior to being appointed to drug-related posts.

"These training courses have certainly made a lot of difference in the attitude of our police officers toward drug users," he added.

As in Indonesia, Calcutta Police are awaiting an amendment to India's National Drug Authority Act in order to better address the harm reduction issue.

"We need a stronger act, a more liberal one, to tackle the problems properly. The amendment will take a year or two," he said.

Mitra also highlighted the need for better interregional cooperation between law enforcers in Asia to combat the spread of HIV/AIDS.

"We are headed in the right direction. The fact that we are having a conference in which government institutes as well as policymakers are also a part is a good sign of better cooperation in the future," he said.

HIV/AIDS status in some provinces as of Dec. 31, 2004

Province HIV+ AIDS Total IDUs w/AIDS Fatalities

Jakarta 1,233 1,272 2,505 846 278
Papua 632 408 1,040 2 107
Bali 283 128 411 50 33
East Java 282 220 502 83 69
Riau, Riau Islands 206 102 306 5 43
W Java, Banten 131 124 255 69 29
Central Java 77 40 117 6 27
North Sumatra 64 75 139 34 25
West Kalimantan 82 79 161 18 17
Yogyakarta 30 18 48 7 7
North Sulawesi 1 55 56 7 27

Source: National AIDS Commission