Indonesia

Hendro was a driver for a private company in Jakarta, Indonesia, when a colleague introduced him to heroin two years ago.

“I started to get addicted,” said Hendro, who prefers to use his first name only. “Soon, my body didn’t feel good if I wasn’t consuming drugs. I couldn’t concentrate. This lasted for about seven months before my life descended into chaos.”

His work suffered and he got into daily arguments with his wife. He would whisper to himself, “This is not right. I will destroy myself. Every day, I kept trying to stay away from drugs, but the craving for the drug was so painful. It was unimaginable.”

One day Hendro heard about an innovative drug programme based in a large house in Bogor, an hour outside of Jakarta. The cheerful building with a freshly cut lawn exudes a warm and friendly atmosphere, which is accentuated by two dogs who greet visitors with a couple of friendly sniffs.

Sam Nugraha founded Rumah Singgah PEKA in 2010. “PEKA is different from other treatment centres, because it is fully voluntary,” he said. “Every client has made their own decision to participate.”

There are 4 million people who inject drugs in the Asia and the Pacific region—that’s one third of the people who inject drugs globally. This places the region at the forefront of the largest injecting drug problem in the world.

A common response to drug use in the region is the confinement of people who inject drugs in compulsory treatment and rehabilitation centres.

“PEKA’s approach cannot be applied to everyone. Clients have to be conscious of what they need to do and ready to make changes,” said Mr Nugraha.

Before participants enrol in PEKA, they undergo a lengthy assessment to determine if the facility fits their needs.

“When I came to PEKA I was determined to recover and to rediscover the person who was lost because of drugs,” recalled Hendro.

Clients discuss with their counsellors the best treatment plan. They can choose to live in or outside of PEKA, but if they opt for the boarding option, they must respect the facility’s zero tolerance for the consumption of drugs while on its premises. Some clients select complete abstinence, others enrol in opioid substitution therapy and for those who wish to continue to inject drugs, PEKA has a needle and syringe programme. All clients are encouraged to have group and individual therapy sessions.

“Ninety per cent of our staff have experience with using drugs,” said Mr Nugraha, “so they understand the challenges clients are facing, as well as the type of support they need.”

Hendro decided to board and to participate in the methadone maintenance treatment programme. A counsellor accompanied him to a public clinic, where the doctor determined his optimal dose of methadone. He started off with 50 mg every day, but after a year has been bringing the dose down.

PEKA works in partnership with public clinics. Staff not only accompany clients to access methadone, but pick up a five-day supply of methadone for individuals who have established a steady routine and bring it back to the facility.

“Public health clinics have limited working hours and so we fill the gap by providing 24-hour services,” said Mr Nugraha. “People can come here at any time.”

Agustina Susana Iswati, Head of the Gedung Badak Health Clinic, agreed. “The cooperation with community groups is very much needed as they know what is really happening.”

People who inject drugs are vulnerable to HIV, hepatitis, tuberculosis and other infectious diseases. HIV prevalence among people who inject drugs is higher than 30% in several Asian cities. Only 30% of people who inject drugs in Asia and the Pacific know their HIV status.

“We offer all our clients access to HIV testing. If the test result is positive, we help them start antiretroviral therapy as soon as possible,” said Mr Nugraha.

Evi Afifah, who is with the Mahdi Bogor Hospital, finds the collaboration with PEKA on HIV services helpful. “PEKA helps us reach our friends who are most in need of HIV testing, treatment and care,” she said.

Since 2010, PEKA has provided a range of services to almost 1000 clients. Follow-up surveys conducted with people who went through the full treatment programme indicate promising results. A significant number of clients reported that their drug dependency and quality of life had improved and their involvement in criminal activities had sharply declined.

This success has won local recognition. The organization was recognized by the Mayor of Bogor as an excellent institution in 2014 and 2016.

“PEKA is an organization that has gone through the test of time,” said Bima Arya Sugiarto, Mayor of Bogor. “With its vast experience, PEKA deserves our recognition, which can also motivate other community groups to be consistent and focused in their work.”

Perhaps the most important endorsement for PEKA is its clients, some of whom now work for the organization.

Iko, who is an HIV peer counsellor, said, “Aside from helping other people who use drugs, I am actually helping myself. That’s the main point. It makes me happy.”

After nine months of living at PEKA, Hendro was able to return home to his family and start working again as a driver. His experience was life-changing.

“At PEKA, I felt embraced as part of a family again. When I was using drugs, I was estranged and abandoned. Here, I found strength again,” said Hendro.

UNAIDS is working to support countries to reach the targets set out in the 2016 United Nations Political Declaration on Ending AIDS, which include ensuring access to combination HIV prevention options, including harm reduction, for 90% of people who inject drugs.

George started using drugs more than 10 years ago. At the time he lived in Jakarta, Indonesia, and worked as a driver for an international company. About one third of people who inject drugs globally live in the Asia and the Pacific region. (Photo 1)

As George’s dependence on drugs became severe, he lost his job and could no longer provide for his wife and young children. “All I could think about was where I would get my next hit. I lied. I stole. I hated myself,” recalled George. (Photo 2)

One day George heard about a novel programme based in a large house in Bogor, Indonesia. Rumah Singgah PEKA is a community-based harm reduction programme that aims to empower people who use drugs to take back control of their lives. (Photo 3)

Sam Nugraha is the Executive Director of Rumah Singgah PEKA, which he founded in 2010. He said, “Rumah Singgah PEKA is different from other treatment centres, because it is fully voluntary. Every client has made their own decision to participate.” (Photo 4)

Most of the staff at Rumah Singgah PEKA have experience with drug dependence. The facility provides a range of services, including group and individual counselling. (Photo 5)

The organization works with public health facilities to help clients access key services. Deni Subhan, Programme Manager at PEKA, often accompanies clients to get their daily dose of methadone. (Photo 6)

Siti Nurfaiza, Programme Manager at Gedung Badak Health Clinic, finds the collaboration with PEKA good. She said, “Methadone is very helpful for the heroin user, since it helps people with drug dependence to maintain their physical, psychological and social activities.” (Photo 7)

Deni Subhan picks up a five-day supply of methadone for clients, who can then access their daily dose at PEKA, which has much more flexible hours than public health facilities. (Photo 8)

George has gradually decreased his methadone dose. He now works for PEKA and is once again able to provide for his family. (Photo 9)

George said, “All of us are entrusted to make our own decisions. If we wish to make a good decision, the community is here to help.” (Photo 10)

A delegation of the UNAIDS Programme Coordinating Board (PCB) conducted a field visit to Indonesia from 22 to 24 October to see how the country has implemented an integrated and decentralized response to AIDS that has accelerated the strategic use of HIV treatment, increased testing and counselling and strengthened HIV prevention services for key populations.

Indonesia demonstrates how a multisectoral approach to HIV, combined with consistent leadership at all levels, is helping the country to stabilize the epidemic, accelerate treatment and provide innovative and comprehensive HIV services. The country’s AIDS response is guided by an investment strategy, developed with support from UNAIDS, which focuses resources and efforts where they are most needed.

“Indonesia’s response shows that cross-sectoral engagement and leadership—including impressive and vibrant civil society involvement—is critical for turning strategies into action,” said UNAIDS Deputy Executive Director Jan Beagle, who was leading the visit. “As we look towards ending the AIDS epidemic by 2030, continued commitment at all levels will be key to effective impact—for AIDS and the broader health and development agenda.” 

According to national estimates, 638 000 people are living with HIV across Indonesia, and latest national data show that new infections are stabilizing, although there are increases among men who have sex with men. Indonesia’s epidemic is largely concentrated among key populations, including sex workers and their clients, men who have sex with men, people who inject drugs and transgender people. While national HIV prevalence is low, a higher burden of HIV is found among key populations and in certain geographic areas, such as urban settings and in the Papua provinces.

The delegation, which included members from Australia, Brazil, El Salvador, Iran (Islamic Republic of), Luxembourg, Ukraine and Zimbabwe, as well as the PCB NGO delegation and UNAIDS Cosponsors, met with a range of national partners, including senior government representatives at the national, provincial and city levels, the National AIDS Commission, development partners, civil society organizations and the United Nations Country Team. The delegation also visited several sites to see examples of scaling up access to HIV testing and treatment and ways of addressing stigma and discrimination.

During a meeting with the PCB delegation, the Acting Governor of Jakarta, Basuki Tjahaja Purnama, highlighted the city government’s response to HIV in the capital. The Acting Governor underscored the significant investments that the local government has made to HIV programmes, including increasing access to HIV treatment, and expressed his commitment to prioritize health, education, employment and housing for people living with HIV, ensuring that no one is left behind.

Over the past years, Indonesia has increased its domestic financing to 42% of its total spending on AIDS. Throughout the visit, political commitment to further increase domestic funding was emphasized at all levels. However, government officials also stressed that international financing remains critical to scaling up the response, in particular for accelerating access to HIV treatment.

Community-friendly services key to a sustainable response

At a gathering of civil society groups, including networks of people living with and most affected by HIV, the delegation was presented with an overview of how youth organizations are mobilizing young Indonesians, as part of the ACT 2015 initiative, to ensure that HIV and sexual and reproductive health and rights remain a priority for the country’s new government and in the next development era.

Site visits to a number of public and private HIV service-providing institutions in Jakarta and Denpasar showcased how community-friendly and community-led services are improving uptake of services and reducing stigma and discrimination. Examples included the country’s main HIV treatment referral hospital in Jakarta, which runs programmes to sensitize staff on the specific needs of key populations at higher risk, and the Yayasan Kertipraja Foundation and the Bali Medika Clinic in Denpasar, where a number of programmes are led by key populations and provide easy-to-access services after work hours and on Saturdays. As well as increasing demand among key populations, such programmes have also led to early uptake of HIV treatment. The National AIDS Commission, with support from UNAIDS, is looking at how to further replicate and scale up such models across the country.

Home to the world’s fourth largest population and with a vast geographical spread, Indonesia is a country of critical focus for the AIDS response.

Given the increasing numbers of new HIV infections in recent years, the government and partners are accelerating action across the country to help increase programming and action to reduce the number of new HIV infections and deaths and to increase access to HIV treatment.

In 2013, a national strategy was adopted to rapidly increase access to antiretroviral therapy, in order to maximize its prevention impact. Through the programme, early initiation of antiretroviral therapy, regardless of CD4 count, can now be offered to pregnant women, serodiscordent couples, all members of key populations living with HIV, and people living with HIV, tuberculosis and/or hepatitis B and C coinfection. The programme is currently being rolled out in partnership with the authorities, civil society, and development and international partners in 13 districts across the country and will be expanded to 75 districts by the end of 2014.

In parallel, Indonesia continues to scale up HIV prevention efforts, focusing on key affected populations. Recent data from 16 cities across Indonesia show that efforts to increase access to condoms—especially for sex workers—and their effective use has lowered the number of sexually transmitted infections, for example syphilis, and therefore reduced the risk of HIV transmission.

“From increasing treatment and prevention programmes, to focusing responses geographically and among key populations, there are examples of progress that now need to be replicated, rapidly, to make further progress,” said UNAIDS Deputy Executive Director Jan Beagle, who made an official visit to Indonesia in April.

A time for action

Partners in the Indonesian AIDS response agree that further scale up must be continued. There were an estimated 76 000 new HIV infections in 2012. The number of people with access to antiretroviral therapy rose to just under 40 000 in 2013 (a 27% increase from 2012). While there may be signs that epidemics among sex workers and people who use drugs are stabilizing in some areas, HIV prevalence among men who have sex with men has significantly increased nationally, from 5.3% in 2007 to 8.5% in 2011, and in Jakarta from 8.1% in 2007 to 17.2% in 2011, according to national Integrated Biological and Behavioural Surveillance 2007 and 2011 data.

“In a decentralized country like Indonesia, we have to translate strategies into progress and action at the provincial and district levels, and to do this we need to make sure we have excellent partnerships,” said Deputy Minister of Health Ali Ghufron Mukti, when meeting with the UNAIDS Deputy Executive Director in Jakarta. “We are working hard with our local authorities in the districts and with civil society and communities,” he added.

Bali is a province heralded as having a growing number of strategies and initiatives that are showing positive results. For example, Bali’s programme to prevent sexual transmission of HIV has been strengthened through updating of regulations on sex work that enable sex workers to have easier and confidential access to HIV and sexual health services. Bali has also been in the forefront of implementing the national programme on the strategic use of antiretroviral therapy, providing treatment to all key populations without reference to CD4 levels.

Community-centred action driving results

Community-centred and community-led services are showing significant results in terms of increasing interest in and uptake of services. For example, despite the complex and sensitive cultural context on the issue of sex between men, the Bali Medika Clinic in Kuta (Bali) is viewed by community groups as friendly to such people. Over the past few years, it has seen an increasing number of clients taking up its anonymous testing and counselling service and referral to early initiation of HIV treatment.

“The Bali Medika Clinic is a community-led initiative. Our services are built around the needs and requests of men who have sex with men. Our clients can enjoy a patient-centred approach and our one-stop service, which is affordable and also confidential,” said Yogi Prasetia, from the Clinic.

United efforts of UNAIDS

Strong partnership among the United Nations on HIV is also helping to support the accelerated efforts in Indonesia. UNAIDS led the development of a Joint Support Programme on AIDS, which represents the combined United Nations efforts to support the Government of Indonesia and its partners in the national AIDS response.

The Programme responds to Indonesia’s identified priorities within the national strategic plan, with particular focus on ensuring increased access to antiretroviral therapy. It particularly aims to maximize the impact of the United Nations’ collective response, harmonize and better coordinate Cosponsor programming, financing and reporting, and reduce duplication and transaction costs.

During an official visit of the UNAIDS Deputy Executive Director, Jan Beagle to Indonesia, national and provincial municipal leaders, development agencies and civil society organizations underlined the importance of scaling up and investing in city-based HIV strategies as a critical action towards accelerating progress in the AIDS response.

Speaking with the National AIDS Commission Director Dr Kamal Siregar, Ms Beagle stressed the importance of focusing on city-based HIV responses at a time when the majority of people living with HIV and from key populations at risk reside and/or work in municipal centres. Dr Siregar noted how scaling up programmes and efforts at the city level will enable greater reach to people in need of HIV services, especially among key populations at higher risk.

Jakarta, the capital city of Indonesia is one of the provinces with highest numbers of new HIV infections in Indonesia. The estimated number of people living with HIV in the city as of 2013 is approaching 100 000. According to national surveillance data, estimated HIV prevalence among key populations at higher risk in the city is higher than national averages with 56.4% prevalence found among people who use drugs, 17.2% among men who have sex with men and 10.5% among female sex workers.

Indonesia’s Deputy Minister of Health echoed the need to make cities central to HIV responses noting that city populations often contain large numbers of young people and that youth focus and engagement for HIV is also critical.

Enhanced city-based focus was also welcomed by the Secretary General of the Association of Southeast Asian Nations (ASEAN), which is spearheading the ASEAN ‘Cities getting to Zero’ initiative. Meeting with Ms Beagle, ASEAN Secretary General Le Luong Minh stressed how the ‘Cities getting to Zero initiative’ is focusing on 13 ASEAN cities and municipal areas—which account for large proportions of HIV burden in their countries (including three in Indonesia)—to catalyze country actions towards the achievement of the 2012 ASEAN Declaration on Getting to Zero New HIV Infections, Zero Discrimination, Zero AIDS-related Deaths.

UNAIDS is working to increase the focus on city-based HIV responses. Cities and their importance within the HIV response will also be discussed at the International AIDS Conference to be held in Melbourne, Australia from 20-25 July.

Parliamentarians from across Asia and the Pacific are urging sustained action on AIDS to ensure an AIDS-free generation in the region. The call came at a Forum held in Bali, Indonesia (25-26 March) where parliamentarians and civil society leaders from 35 countries in Asia-Pacific gathered to assess the progress made and the challenges remaining to achieve the Millennium Development Goals (MDG) in the region.

“We are just starting to see significant results in achieving the MDGs. We cannot abandon them; we must take the MDG agenda forward,” said Hon P Kamalanathan P Pancanathan, Member of Parliament from Malaysia. “We have seen important health, human rights and development gains through the AIDS response that can strengthen other work in global health and sustainable development,” he added.

Calls for a future based on human rights, equality and sustainability resonated throughout the Forum. Rapid increase of access to antiretroviral treatment, the meaningful engagement of communities in the design and roll out of programmes and the removal of laws, policies and practices that hamper access to HIV services for people living with HIV and key populations at higher risk were cited as critical priorities to ensure success in the response to AIDS.

“With political commitment, community mobilization, adequate funding and evidence-based approaches, the end of AIDS and the emergence of an AIDS-free generation can be a shared triumph of the post-2015 era,” said United Nations Secretary-General’s Special Envoy on AIDS in Asia and the Pacific, Prasada Rao.

Effective spending and shared responsibility were linked to results across health and development goals. “We have to ensure smart spending – making sure funds are focused where they are most needed and where they produce most efficiency – which in the Asia Pacific region means focusing on key populations at highest risk of HIV,” said Steven J Kraus, Director of UNAIDS Asia and the Pacific Regional Office at the Forum. “As representatives of the people—including and especially the most vulnerable—parliamentarians have a key role to play in giving voice to the voiceless,” he added.

The parliamentarian and civil society Forum took place alongside, and fed into, the fourth meeting of the High-Level Panel of Eminent Persons on the Post-2015 Development Agenda, hosted by the President of Indonesia as Panel co-chair. As part of the Forum, a selected delegation of 20 senior parliamentarians and local elected representatives shared with the UN Secretary-General’s High-Level Panel their recommendations about key priorities identified for consideration in the crafting of the post-2015 development agenda.

The Parliamentarians and Civil Society Forum was hosted by the Indonesian Parliament, Indonesian Forum of Parliamentarians on Population and Development (IFPPD), and UNORCID, and co-organized by United Nations Millennium Campaign and the Asian Forum of Parliamentarians on Population and Development (AFPPD) with support from the Rockefeller Foundation, and in collaboration with UNAIDS and a number of other UN agencies, global civil society networks, international nongovernmental organizations, and parliamentary networks.

UNAIDS Executive Director Michel Sidibé met with the Head of the President’s Delivery Unit for Development Monitoring and Oversight, Kuntoro Mangkusubroto in Jakarta on 24 October 2012.
Credit: UNAIDS/E.Wray

Countries pledged to reach eight Millennium Development Goals (MDG) by 2015, including reversing the AIDS epidemic. Much progress has been made in reaching these goals. However, there is recognition that the world will still need to focus on these goals beyond 2015. Therefore, the United Nations Secretary General Ban Ki-moon has appointed Indonesia, along with the United Kingdom and Liberia, to co-chair a High-Level panel tasked with setting future development priorities beyond 2015.

Indonesia’s Head of the President’s Delivery Unit for Development Monitoring and Oversight and advisor to Indonesia’s President on the  post 2015 development agenda, Kuntoro Mangkusubroto committed to not only maintaining but expanding key global development goals during a meeting with UNAIDS Executive Director Michel Sidibé in Jakarta on Wednesday.

“I would like to congratulate Indonesia for leading the work to develop the post 2015 development agenda,” said Mr Sidibé. “This shows trust in Indonesia, not only as a country that is influencing the agenda in Asia but in the world. This exercise is a unique opportunity to really bring the debate around creating an inclusive society and redistribution of opportunity to the world table.”

Mr Kuntoro agreed that the current MDGs had greatly contributed to the world’s development. “We are not going to close the MDG chapter and open a new book. We think MDGs are good and we need to maintain them, but we also want new social issues like social inclusiveness to be addressed,” said Mr Kuntoro.

Dialogue with civil society

After meeting with the President’s advisor, Mr Sidibé had a dialogue with civil society organizations representing people living with HIV and key affected populations in Indonesia.  The discussion, moderated by Professor Irwanto and held at the AIDS research centre of the Atma Jaya University in Jakarta, reviewed current HIV policies and their implementation, as well as to hear the concerns of civil society on how HIV should be addressed in the post 2015 development agenda.

Professor Irwanto reminded the gathering about the important role played by civil society in the AIDS response. “The problem is that, right now, we feel that civil society is getting less and less attention. We hope that the role of civil society is not only maintained but strengthened because the achievements so far could not have been reached without civil society,” said Professor Irwanto.

Civil society participants discussed a wide variety of concerns including ensuring that civil society is given the opportunity to contribute to the development of national guidelines on HIV, the need to ensure antiretroviral therapy is made accessible to everyone needing treatment and how to support women living and affected by HIV.

UNAIDS Executive Director Michel Sidibé participating in a dialogue with civil society organizations representing people living with HIV and key affected populations in Indonesia. 24 October 2012.
Credit: UNAIDS/E.Wray

“Many of you have been helping us to frame the HIV response in a different way. You have changed the dynamic of social mobilization,” said Mr Sidibé. “Let us work together. I am asking you to help us to ensure that AIDS remains high on the development agenda. Let us not miss the opportunity to bring to shape the debate on the post 2015 development agenda,” he added.

Indonesia spearheaded a movement among countries in the Association of Southeast Asian Nations (ASEAN) to reach the global vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths through the ASEAN Cities Getting to Zero initiative. The move is part of an effort to strengthen collaboration between countries in the region to control the epidemic. Jakarta was chosen as one of three Indonesian cities participating in the programme.

Mr Sidibé visited Jakarta’s model community health centre, located in the city’s Tambora district, which is participating in the ASEAN Cities Getting to Zero project. The centre provides comprehensive HIV services, including voluntary counselling and testing, prevention of mother-to-child transmission, HIV treatment care and support, as well as methadone treatment for people who use drugs.

UNAIDS Executive Director, Michel Sidibé met with Indonesia’s Minister of Health, Nafsiah Mboi as part of his two-day trip to Indonesia.
Credit: UNAIDS/E.Wray

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.”

UNAIDS Executive Director, Michel Sidibé toured the Narcotics Prison Cipinang in East Jakarta where he met with prison authorities and visited the clinic where antiretroviral treatment and methadone services are provided.
Credit: UNAIDS/E.Wray

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.

The Ministry of Health hosted a dialogue between Mr Sidibé and faith based organizations, including Islamic, Christian, Hindu, Buddhist and Confucian religious groups.
Credit: UNAIDS/E.Wray

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.

Credit: MC ASEAN/Nyoman Budhiana

The Heads of State and government from the ten countries that make up the Association of Southeast Asian Nations (ASEAN) have committed to making Zero New HIV Infections, Zero Discrimination and Zero HIV Related Deaths a reality, in a declaration adopted at the 19^th ASEAN Summit in Bali, Indonesia (17-19 November 2011).

Reinforcing the commitments made at the High Level Meeting on AIDS in June 2011, the leaders—from Brunei Darussalam, Cambodia, Indonesia Lao People’s Democratic Republic, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam— pledged to, by 2015, halve sexual transmission of HIV and HIV transmission among people who use drugs and ensure accelerated efforts to achieve the goal of universal access to antiretroviral treatment. They also agreed to push towards eliminating new HIV infections among children in the next five years.

The 2011 Declaration details specific commitments by the ten ASEAN countries to ensure that adequate financial resources are provided for scaling up evidence-based HIV prevention programmes for key populations at higher risk such as people who use drugs, sex workers, men having sex with men and transgender people.

"We underline the importance of effective and comprehensive response to prevent and reduce the number of new infections and provide appropriate treatment, care and support to key affected populations and other vulnerable groups," said President of Indonesia and Chair of the 19^th ASEAN Summit, Susilo Bambang Yudhoyono, in his Chair’s Statement at the close of the Summit.

The ten ASEAN nations underlined the importance of ensuring financial sustainability, national ownership and leadership for improved regional and national responses to HIV. Through the declaration they committed to ensuring mobilization of a greater proportion of domestic resources for the AIDS response in the spirit of shared responsibility.

“These bold commitments by ASEAN leaders recognize the need for shared responsibility and that we are at a game changing moment for the AIDS response,” UNAIDS Executive Director Michel Sidibé . “To capitalize on the opportunities before us, the world must invest sufficiently today, so we will not have to pay forever.”

Through the Declaration, ASEAN Sectoral Ministerial Bodies as well as other relevant bodies are tasked with implementing the outlined commitments with all ASEAN Member States encouraged to support in accomplishing the goals.