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Indonesia’s Minister of Health promises to transform the national response to AIDS
<p>Feature story</p>
October 23, 2012

Indonesia’s Minister of Health, Nafsiah Mboi, pledged to scale up HIV testing and treatment programmes, leading to zero new HIV infections and zero AIDS-related deaths. Minister Mboi met with UNAIDS Executive Director, Michel Sidibé on Tuesday, on the first day of his two-day trip to Indonesia.

Indonesia is one of several countries in Asia where new HIV infections are growing. The Ministry of Health estimates that more than 600 000 people are living with HIV and that there are more than 76 000 new HIV infections each year. Currently HIV treatment coverage is at less than 20%.

But, Minister Mboi promised a new approach to the country’s AIDS response. She said she will ensure that everyone will know their HIV status and have access to HIV treatment. Health authorities will focus on 141 districts where key affected populations are the highest. Indonesia’s epidemic is concentrated on key populations at higher risk such as drug users, sex workers and their clients and men who have sex with men.

Indonesia is taking an active role in the AIDS response in Asia. As chair of the last year’s ASEAN (Association of South East Asian Nations) summit the country pushed for the adoption of the ASEAN Declaration of Commitment in Getting to Zero New HIV Infections, Zero Discrimination and Zero AIDS-related deaths.

Indonesia also plans to become one of several countries in the region to offer universal health care by 2014. The Ministry of Health says that HIV treatment will be included in the health coverage.

“Indonesia is a key partner in the drive to end the AIDS epidemic,” said Mr Sidibé. “Universal health coverage is a game changer for Indonesia. I am delighted to know that HIV treatment will be included in this national programme. This sets the stage for sustainable funding of HIV programmes.”

Domestic investments in the HIV response have been increasing significantly in Indonesia since 2010, but there still is a large funding gap and in 2015 Indonesia will no longer be eligible for funding from the Global Fund to Fight AIDS, Malaria and Tuberculosis.

“Indonesia is trying to ensure the sustainability of HIV care for people living with HIV once donor countries stop giving funds,” said Minister Mboi. “The Ministry of Health is preparing an exit strategy. We plan to cover 100% of the HIV treatment by the national government budget,” she added.

Health authorities are increasing efforts to focus HIV programmes on communities that need the most attention. The sharing of needles among people who use drugs has been one of the drivers of the HIV epidemic in Indonesia. Since 2009, the Directorate General of Corrections says it has scaled up its HIV programmes at 149 corrections facilities in 25 provinces.

Mr Sidibé toured the Narcotics Prison Cipinang in East Jakarta, which is one of eleven model prisons implementing a comprehensive AIDS programme. He met with prison authorities and then went on a tour of the prison, visiting the clinic where antiretroviral treatment and methadone services are provided. He also toured the occupational training centre where inmates learn new skills including baking, sewing and handicrafts.

“My visit today shows that even in prisons we can restore the dignity of people,” said Mr Sidibé. “Prison can be a transformative experience. The Indonesian government is showing great innovation and courage with its remarkable harm reduction and HIV programme in prisons. I hope the programme inspires other countries to show the same entrepreneurship,” he added.

On Tuesday, the Ministry of Health hosted a dialogue between Mr Sidibé and faith based organizations, including Islamic, Christian, Hindu, Buddhist and Confucian religious groups. Religious leaders are important community members and their cooperation is key to ensuring support for HIV prevention, treatment and care.  The leaders agreed that faith based organizations need more education and training in HIV issues, so that they can help their communities.

Anggia Ermarini, Health Unit Secretary of Indonesia’s Ulama Council, the country’s Muslim clerical body said, “Many religious leaders do not understand about AIDS. We want the United Nationsto to tell us about the situation in our country.”

Franz Magnis Suseno, a Jesuit priest from the Institute of Philosophy Driyakara said that he thought that religious organizations needed to start to educate people about sexuality. He said there was a high resistance to sex education but that it was necessary.

Mr Sidibé is in Indonesia at the start of a three country trip to Asia, where he will also visit Myanmar and Thailand.