24 August 2009

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Wednesday August 19, 2009
Following Jakarta in tackling AIDS

The openness and inclusiveness of the Indonesian local organising committee have been impressive.

IT was a subtle but significant moment for those of us who have worked in this field for a very long time. When Susilo Bambang Yudhoyono, President of Indonesia, fifth most populous and largest Muslim country in the world, addressed his “brothers and sisters living with HIV”, all of us sitting in the audience couldn’t help our prickly eyes.

In the dramatic setting of the Garuda Wisnu Kencana park in Bali, President Yudhoyono was opening the 9th International Congress on AIDS in Asia and the Pacific (ICAAP). No head of government has deigned to open the conference since the 5th in Kuala Lumpur in 1999. But the Bali conference was exceptional in so many ways.

Before the opening, the First Lady of Indonesia, Ibu Ani Bambang Yudhoyono, hosted a lunch for several AIDS Ambassadors from abroad in her capacity as National AIDS Ambassador. This means that she is committed to upholding the AIDS cause in the country, talking about it and ensuring that the best prevention, treatment, care and support programmes are employed in Indonesia.

At the official opening, she read out a declaration by all the AIDS Ambassadors and Champions present at 9th ICAAP, committing themselves to being advocates for AIDS, particularly in fighting stigma and discrimination against those most at risk of infection and those living with HIV.

The President’s speech itself set the tone for the entire conference where the fight to contain the spread of AIDS in Asia and the Pacific had to be based on human rights principles, protecting the rights and dignity of those most at risk of becoming infected .

As at the United Nations General Assembly Special Session on HIV/AIDS in 2001 where many countries, including ours, fought to have a listing of the most vulnerable populations excluded from the resulting document, Indonesia has no problem talking about injecting drug users, sex workers, migrant workers or even men who have sex with men.

Indeed, in my two years working with the Indonesian Local Organising Committee, their sheer openness and inclusiveness impressed me. Indonesia, again unlike us, has a National AIDS Commission (NAC), an autonomous body that reports directly to the President, headed by a powerful and very HIV-savvy woman Nafsiah Mboi.

The NAC is a multi-sectoral body, comprising not only doctors and academics but also the private sector, NGOs and representatives of key affected groups including people with HIV. In fact, the NAC has even provided office space for the local networks of these community groups in the same building.

These communities, including youths, were present in all areas of the organising of the conference. They worked on many of the committees, in the secretariat office and as volunteers. And the entire conference was enriched by it.

Indonesia’s AIDS epidemic is younger than ours but has also expanded at a much faster rate. In Jakarta, HIV rates among injecting drug users is exceptionally high and in the far-flung province of Papua, sexual transmission has taken a great toll. Yet, with the help of donors, Indonesia has responded to the challenges with greater speed and much less angst than we have.

Every province now has an AIDS Commission replicating the National one and does their own programmes to deal with HIV issues that may be different from other areas. In this way, there is no one-size-fits-all programme handed down from a central authority. Needle exchange and methadone programmes in Bali for instance have greatly reduced the incidence of HIV among drug users there.

At the ICAAP, we talked about successful programmes, new challenges and were also reminded of the gaps. At the last plenary, just as Ibu Nafsiah of the NAC was speaking, we were interrupted by a demonstration calling for drugs for Hepatitis C, a common co-infection for many drug users with HIV. It was a peaceful and polite demonstration and Ibu Nafsiah immediately responded that she would look at the Hepatitis C issues in Indonesia and find ways to redress them.

Rarely do we ever see a government official take note and act so quickly as she did.

If Indonesia does well, we in Malaysia benefit too since our people have much interaction with one another. If we do well, Indonesia gains too.

Unfortunately while we are committed to fighting AIDS, we also fight shy of a very crucial part of that battle, the protection of the rights of those vulnerable to and living with HIV. Unlike Indonesia, we don’t have government policies specifically addressing human rights issues. Indeed the words rarely get mentioned in government circles.

Health is a human’s right. If we protect the right to health of the most marginalised and vulnerable groups of people in our society, we will advance the health of the entire nation. When will we understand that?