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.