Sustainable Efforts Urged to Guarantee Supply and Access

KOMPAS/DEONISIA ARLINTA

Antiretroviral drug combination type TLE or tenofovir, lamivudine, and efavirenz. The Ministry of Health claims that the availability of this drug is safe until the end of 2019.

JAKARTA, KOMPAS – With the government aiming to eliminate the HIV (human immunodeficiency virus) epidemic in the country by 2030, breakthroughs and strategic solutions are needed to ensure the availability of, and facilitate access to, antiretroviral (ARV) drugs.

In the last few days, this issue has become a concern of many circles, including parties that are active in the country’s HIV control programs.

Prof. Irwanto at the Psychology School of Atma Jaya Catholic University (Unika), Jakarta, said that Indonesia still lagged far behind other countries in the progress of its anti-AIDS (acquired immune deficiency syndrome) program, citing the high dropout rate prevalent among HIV/AIDS patients in ARV therapy.

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Stopping the medication would cause the uncontrollable replication of the virus in the body and potentially make it transmissible.

“The issue of [treatment] dropout among HIV/AIDS patients needs serious attention. They need mental and psychosocial support," Irwanto, who is also a researcher at the Unika Atma Jaya HIV/AIDS Research Center, said in Jakarta on Tuesday (27/7/2021).

ANTARA FOTO/RAISAN AL FARISI

Students from various campuses conduct an antidiscrimination campaign in the Car Free Day area in Dago, Bandung, West Java, on Sunday (2/12/2018). Held in commemoration of World AIDS Day, the antidiscrimination campaign encouraged the public to shed the social stigma against people with HIV/AIDS.

Data from the Health Ministry estimates that 543,100 people in Indonesia were living with HIV as of March 2021. Of this figure, 144,632 people were undergoing therapeutic treatment and 68,508 had stopped treatment.

Without any significant efforts to increase access to drugs for people living with HIV/AIDS (PLWHA), it would be difficult to achieve control and prevention of transmission of the virus. Meanwhile, stigmatization and discrimination were still occurring, even by those within the government structure.

Indonesia AIDS Coalition (IAC) executive director Aditya Wardhana said the government should envisage more strategic, long-term measures to ensure the availability of and access to ARV services and drugs for PLWHA through efforts such as encouraging domestic production of ARV drugs.

"The provision of multi-month ARV drugs does exist, but it is a short-term solution and the service is not fully accessible yet," he said.

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Given that Indonesia had been unable to import ARV drugs from India because the South Asian country was severely hit by a wave of Covid-19 infections late last year, the government was urged to start thinking about how to become nondependent on imported ARVs.

"Even though their efficacy is as yet unproven, Covid-19 drugs have been pushed for [mass] production and distribution. ARVs that have been proven effective for HIV [therapy] should be able to do likewise," Aditya said.

At present, only about 25 percent of PLWHAs were receiving therapeutic treatment.

Domestically produced ARV drugs would be cheaper, so more people with HIV would have access to the medicines. At present, only about 25 percent of PLWHAs were receiving therapeutic treatment.

East Java Deputy Governor Emil Elestianto Dardak said the provincial administration had moved to involve close relatives of PLWHAs to help treatment dropouts start retaking their medication.

KOMPAS/ADHITYA RAMADHAN

International AIDS Society (IAS) Conference on HIV Science ke-10 di Mexico City, Mexico

Community health centers (puskesmas) and community institutions had also been mobilized to identify and encourage dropouts to resume their treatment.

The provincial governments of Papua and West Java also said they were aware about the significance of involving close relatives in efforts to optimize HIV treatment coverage.

“From our monitoring, people with HIV are tired of taking ARVs because of a lack of attention from their families. Given that, we are training their close relatives to [accompany them] in their ARV therapy,” said Beeri I.S. Wopari, who heads the AIDS, TB and Malaria Control Center at the Papua Health Office.

Jakarta has an outreach program called Sehati that aims to reincorporate people with HIV who have stopped taking their medication. To facilitate access to ARV drugs, they are delivered through couriers or on-demand motorcycle delivery services. (TAN/ADH/NIK/ETA/TAM/FLO)

(This article was translated by Musthofid)