Indonesia: HIV and DRUGS
The Government of Indonesia has proactively responded to the HIV challenge. It established the National AIDS Commission by Presidential Regulation in 2006, developing a national strategy in 2007 and a National Action Plan. These plans and strategies are fully funded until 2014. In the country as a whole, national HIV prevalence is low at approximately 0.02%. There are an estimated 186,257 people living with HIV.
Despite low national prevalence, regions of Indonesia and some demographic groups have HIV rates at epidemic levels. In Java, Bali and some northern provinces of Sumatra, there is a concentrated HIV epidemic, mostly among injecting drug users. In Papua and West Papua provinces there is a generalized epidemic, which is primarily driven by unprotected heterosexual encounters.
Injecting drug users and prisoners constitute two groups with epidemic levels of HIV. There are an estimated 105,784 (range 73,663 - 201,131) injecting drug users in Indonesia. Among cumulative AIDS cases reported until December 2010, 38.3 per cent were among people who inject drugs. Prisons, due to constant overcrowding, poor nutrition and limited access to health care, leave prisoners at-risk to HIV. The Department of Corrections reported that there were 133,252 people incarcerated in August 2010. HIV prevalence among males in correctional settings is 1.1% and among women it is 6%. HIV risks include unsterile needle and syringe use, unprotected anal and vaginal sex, piercing, genital modification and tattooing.
The Government of Indonesia has also sought to respond to the challenges of drug abuse and drug dependence. In 2009 the Government of Indonesia passed legislation (Law 35/2009) which, among other dictates, classifies drug users as patients and not criminals. This is a positive step in more effectively handling drug users and drug dependence. The Government supplemented its approach by issuing a decree designating the National Narcotics Board (BNN) as the key agency with responsibility to lead the response to drugs.
Though the recently passed legislation represents progress, there exist challenges to the Government of Indonesia in responding to drug use and dependence. In 2008 the BNN estimated that there were 3.3 million drug users in Indonesia, of which 26 % were 'experimental' users and 27 % were 'regular' users. Of the remainder, 40 % were drug dependent non-injectors and 7 % of drug dependent injectors. In seeking to delay use and provide treatment for these drug users, the Indonesian Government's efforts in this area will need to focus on redefining the approach taken to 'primary prevention' and also the way the in which courts will handle cases of drug use. This includes education related to evidence based drug use and community based (i.e. non correctional) alternatives to sentencing. This multi-sectoral challenge will require the development of new regulations which will impact on many other government agencies, and thus mandate increased inter-agency cooperation and communication.
Drug users, particularly injecting drug users, face a very high risk of contracting HIV. They also face discrimination the possibility of lengthy detention, limited access to medical treatment. Indonesia has deemed drugs a serious national issue and in 2009 the Indonesian Government passed a narcotics law (35/2009) which refers to drug dependent people as patients, not criminals. New policy and legal measures which address drug misuse and dependence are increasingly evident.