We have to admit that the realization of overcoming the HIV & AIDS in Indonesia is still far from the target to be able to end AIDS by 2030. Especially now that everyone is concentrating on the issue of the Covid-19, overcoming the HIV & AIDS has become neglected and seems to be forgotten. President Joko Widodo himself has given an instruction at the Cabinet Meeting on May 29, 2020 (for the recovery of the national economy from the impact of Covid-19) that tackling infectious diseases is one of the big agendas that must be resolved immediately, one of which is reducing the number of HIV & AIDS.
In the Kompas Talks Webinar “Will Indonesia End AIDS in 2030?“ on June 23, 2021, we are being reminded of the urgency of the HIV & AIDS. This webinar was organized by Kompas Daily (Harian Kompas), in collaboration with USAID, UNAIDS and Jaringan Indonesia Positif (JIP), also attended by a number of guest speakers such as Dr. dr. Maxi Rein Rondonuwu (from Ministry of Health), Mr. Abetnego Panca Putra T. (from the Presidential Staff), Ms. Nafsiah Mboi (HIV & AIDS Advocacy Activist), and Meirinda Sebayang (Chairman of JIP).
Prevention is better than cure, so keep in mind that to end HIV & AIDS are not only focused on handling, but all efforts to prevent transmission must also be intensified in order to reach zero new infection (Three Zeroes target: Zero New Infection, Zero AIDS-Related Death, Zero Discrimination). So, how is the progress of HIV & AIDS prevention in Indonesia? How is the reality on the ground? What can be done to tackle the HIV & AIDS in the midst of the Covid-19 pandemic?
According to Mr. Abetnego, the target of the 2020-2024 RPJMN is to reduce the incidence of HIV infection from 0.24/1000 population in 2018 to 0.18/1000 in 2024. To make it happen, there are at least three things that can be done, namely strengthening social services for PLWHA (People Living With HIV & AIDS), improving basic health services by paying special attention to infectious diseases including HIV & AIDS, as well as improving the quality of children, women and youth through preventing the spread of HIV & AIDS and sexually transmitted diseases. All of this is covered by the Regulation of the Minister of Health Indonesia No. 21 of 2013 concerning the treatment of HIV and AIDS as well as being a legal protection, guarantee of life quality improvement and the rights to life of PLWHA.
Then, what about protecting the rights of people who are vulnerable to HIV & AIDS? This concerns the issue of stigma and discrimination that is still circulating for key populations who are vulnerable to HIV & AIDS such as sex workers, injecting drug users (IDUs) and the LGBT community. To be able to eliminate stigma and discrimination, the government must provide protection for the rights of key populations. Because if health services can be implemented properly, new cases of infection can be prevented.
The reality on the ground is that many of the rights of PLWHA and key populations are neglected and cannot be fulfilled. Mrs. Nafsiah and Meirinda Sebayang explained some points which opened our eyes that the issue of HIV & AIDS is not just a health issue, but also intersects with social and legal areas. These points include:
- Most PLWHA admit that it is difficult to get dental health services because dentists are afraid to serve PLWHA. Therefore, people living with HIV have the right to get integrated health services.
- There are still many children with HIV & AIDS who have to drop out of school, so their rights of education is not fulfilled.
- Until now, most children with HIV & AIDS have been forced to take adult medicine packages that are crushed to match the dosage and needs of the child.
- Key populations who are vulnerable to HIV & AIDS are still often discriminated against and stigmatized by health workers which causes them to be reluctant to carry out examinations.
- Stigma and verbal discrimination against women and young people living with HIV in the community still occur.
Meirinda Sebayang likens the handling of HIV & AIDS cases in Indonesia to a house, where all the elements needed are already there. Starting from government strategies and policies as pillars, fulfilling access to examinations and treatment as a roof, monitoring and evaluation as the foundation. However, it’s like there is a dark cloud over the house that will become a storm and want to destroy the house, which is stigma and discrimination in the society.
Answering the issue of stigma and discrimination, dr. Maxi explained that the most basic thing to do is to educate children and young people about HIV & AIDS as early as possible, through a curriculum at the school level that introduces them to HIV & AIDS. Furthermore, through religious institutions, religious leaders can convey messages in the texts of sermons or lectures that can foster a sense of tolerance. Then no less important, the role of information media institutions is expected not to provoke news related to HIV & AIDS in order to eliminate stigma in society.
Ideally, HIV & AIDS testing should coincide with the implementation of counseling, because counseling is very important to change behavior and protect others and oneself. In providing counseling services, it is not easy to gain the trust of PLWHA and key populations, therefore the government can cooperate with civil society organizations or communities that care about human rights and provide financial assistance to provide quality resource training.
In order to facilitate the discovery of HIV & AIDS cases, Mrs. Nafsiah suggested an integration of examinations. For example, in pregnant women, it can be included with the examination of HIV & AIDS, Syphilis, and other infectious diseases. If a positive case is found, then one of the counselor’s tasks is to guide PLWHA to immediately take treatment. Currently, the government is focusing on ensuring the availability of infrastructure for HIV & AIDS services in health facilities, especially the availability of diagnostic test kits and appropriate medicines, both in good quality and in sufficient quantity.
The government will also continue to make improvements, starting from planning and budgeting, equitable distribution of needs to areas that are difficult to access logistically, as well as strengthening monitoring & evaluation across ministries/agencies on a regular basis, so as to resolve existing obstacles without being burdened with significant cost problem.
As long as the Covid-19 pandemic continues, national priorities such as eradicating HIV & AIDS may not run optimally. However, the government is learning more about doing digital transformation for data management and health applications for the sake of data transparency and facilitating access to health information. The Covid-19 pandemic has finally forced all of us to move more quickly and aggressively in dealing with this problem.
Angsamerah itself as a foundation, institution and private primary healthcare facilities is ready to cooperate with various parties in providing optimal, quality, friendly, and stigma-free health services to the society. Let’s use the next nine years to work together to end HIV & AIDS!
Webinar Kompas Talks: “Will Indonesia End AIDS by 2030?”