UNIVERSAL ACCESS


 National HIV programme and response 

In 2007, the National AIDS Commission launched the HIV/AIDS Response Strategies 2007-2010. Key objectives include HIV prevention by targeting high-risk behaviour and vulnerable populations, and providing medical treatment, care, and support services to people living with HIV. The Strategy encourages greater stakeholder involvement in the HIV/AIDS response; more partnerships between the government, professional organizations, civil society, NGOs, the private sector, as well as strengthened policy coordination in HIV/AIDS efforts at national and local levels.

 

In January 2004, the Sentani Commitment was signed by Indonesian central and provincial governments to reach the following goals: promoting condom use in every high-risk sexual activity; promoting harm reduction practices among IDUs; providing ART to at least 5,000 PLWHA by end 2004; reducing discrimination against PLWHA; establishing active provincial and district AIDS committees; developing laws and regulations conducive to HIV/AIDS prevention, care and support programmes; and expanding information, education and communication efforts, including religious instruction, to reduce the spread of HIV/AIDS. The Commitment was re-endorsed in July 2005 by 14 provinces.


To increase and improve access to ART for PLWHA, the Ministry of Health developed national guidelines for ART and case management, as well as policy initiatives, which are currently being undertaken. Indonesia has 296 VCT clinics and 153 hospitals that provide free ART, 19 of which run PMTCT programmes. In addition, there are 20 referral networks for Integrated Management Adult Illnesses.


Weak institutional and human resource capacities however, hinder national efforts to extend ART among PLHWA. National AIDS programmes reach a limited number of injecting drug users and sex workers with their HIV prevention, care and treatment strategies. Stigma and discrimination limit the successful delivery of any HIV intervention. Implementation programmes face other challenges such as weak HIV programme management, uncoordinated interventions between partners and the limited capacity of the HIV surveillance system.

Internal and cross-border migrants are recognized as a vulnerable and sometimes at risk group, but limited national capacity exists to address their HIV issues.

The Ministry of Manpower and Transmigration and the Ministry of Health have developed policies on medical testing for migrants that prohibit using HIV test results in recruitment. However, because in most cases destination countries require HIV testing as part of the recruitment process, migrant workers undergo thorough mandatory medical tests, including an HIV test, under the responsibility of recruitment agencies before employment.

In 2006, the Government accredited 119 clinics to perform HIV testing. Prospective migrants are not always informed of test procedures or their purpose, and pre- or post-test counseling and HIV prevention and information services are not given to migrant workers. There is also no standardised referral system to provide care, support and treatment services to those found HIV positive, although there are currently several institutions in Indonesia that provide those services to PLWHA and that can be accessed by migrant workers.

Recruitment agencies are responsible for providing health and reintegration services to repatriated migrant workers under the 2004 Placement and Protection of Indonesian Migrant Workers in a Foreign Country. Undocumented migrants or trafficked persons do not benefit from this decree. Migrant workers found HIV positive in destination countries receive no treatment or referral services before being repatriated.

The Medical Service Centre (Pusat Pelayanan Medis, or PPM) of Raden Soekanto Hospital in Jakarta provides medical services to migrant workers and trafficked persons in cooperation with IOM and assists their reintegration to their villages with the help of a local non-profit organization.



 

 

 

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