The tip of the iceberg

The tip of the iceberg

It is certainly not to sound an undue alarm that we quote the
facts and figures that follow. But we believe it is advisable
that we all take heed of the information revealed by public
health expert Ascobat Gani at a seminar in Jakarta over the
weekend.

Addressing the audience of the seminar held under the ongoing
Australia Today '94 program, Gani said that a possible upsurge of
Acquired Immune Deficiency Syndrome (AIDS) cases in Indonesia
might occur in the not so distant future and warned that such a
turn might place too heavy a burden on the nation's health
funding resources.

The number of people in Indonesia who are already infected by
the Human Immunodeficiency Virus (HIV) is at present officially
put at 213, he said. However, because as a rule official
estimates show only the tip of the iceberg, it can be assumed
that the great majority of cases remain unknown. This is the case
in developing countries in general, because cases either go
unrecognized or unreported. In Indonesia, officials are reported
to have acknowledged that the actual number could be 200 times as
high as the one recorded.

To be sure, a little more than 42,000 people does not sound
like many, given the total of HIV-infected people so far recorded
worldwide. According to a recent report published by the
Washington-based Worldwatch Institute, 15 million to 23 million
people have been infected by the virus worldwide since the
1970s. Of those, some three million to five million have
developed AIDS and about two-thirds of that number have died.
Last year alone, between two million and three million people
around the world were reported infected by the HIV virus which
causes AIDS.

One clear trend cited in the report is that despite an
increased awareness of the disease, the HIV/AIDS pandemic is
continuing to spread unabated and the cases of AIDS that develop
from HIV infections during the next decade could bankrupt the
health care systems in many countries. A recent report published
by the World Health Organization (WHO) even noted an explosive
increase of people infected by the HIV virus in Southeast Asia.

Clearly, in the light of these developments, more effective
measures to stem, or at least slow down, the progress of the
disease is called for. At present, according to Dr. Gani, the
government can provide only 30 percent of health expenditures
while "the majority of people rely on out-of-pocket payment
mechanisms". This cost burden appears to be bound to grow in the
future. The problem is that while poverty-related diseases, such
as infections and tuberculosis remain prevalent, affluence-
related diseases such as heart disease are increasing.

Considering all that has been said, it seems clear that
preventive measures are in order to fight the growing AIDS threat
in this country. Unfortunately, this is easier said than done,
especially since established habits and preconceptions have to be
dealt with. Perhaps it is time we opened our minds and tried to
learn from the experience of the industrially advanced countries,
such as the United States and some Western European nations,
where the HIV/AIDS pandemic is reported to have about leveled
off.

It seems that in dealing with this admittedly fearful disease,
many of us tend to be either too indifferent or too nervous, as
was demonstrated by the rejection some time ago of the world-
renowned basketball star Earl "Magic" Johnson. We believe it is
important that a thorough awareness of AIDS is established in
this country, particularly among the young. To do this, however,
it is imperative that we look at the problem calmly and
rationally, and then utilize all the resources we have at our
disposal to stem the disease. Frightening as it may be, we
believe that it is not something against which nothing can be
done.