Jakarta Globe (09.10.2013)
In 2007, Indonesia’s Health Ministry estimated that more than 7 million Indonesians—more than 2 percent of the country’s population—had hepatitis C. Approximately half of hepatitis C-infected people could progress to chronic liver disease, and one-third could develop liver fibrosis or cancer. HIV-infected people who injected drugs were particularly vulnerable, since HIV tripled the risk for liver disease and death.
Suhendro Sugiharto, program manager at the Indonesian Drug Users’ Network (PKNI), reported that injection drug users often could not access harm reduction strategies to prevent hepatitis C and recommended hepatitis C treatment. PKNI research with drug-using communities in eight Indonesian cities revealed that nearly two-thirds of drug users received harm reduction services, but half of those accessing harm reduction services never received hepatitis C testing and treatment information.
To determine proper hepatitis C treatment, patients needed diagnostic tests that cost up to $580, three times the average Indonesian’s monthly salary. Each of the six hepatitis C genotypes responded differently to treatment. Pharmaceutical companies Merck and Roche held the license to provide hepatitis C treatment in Indonesia and other Southeast Asian countries. PKNI and other international advocates recently demanded that Merck and Roche cut prices to increase access to hepatitis C treatment.
The Indonesian government provided some public support for hepatitis C treatment through insurance programs for government employees, employees of some businesses, and low-income individuals. However, most Indonesians either did not know about available programs or did not qualify for these programs.
Indonesia’s Minister of Health Nafsiah Mboi announced that National Health Insurance would cover hepatitis C treatment beginning in 2014. The Health Ministry established a national program focused on hepatitis C in 2011 and would begin to implement a national plan sometime between 2015 and 2019.