Transcript Persaudaraan Korban Napza Indonesia Indonesian Drug

The Indonesian Experience:
Government and civil society
partnership model for expanding
coverage of harm reduction
Dr. Nafsiah Mboi, SpA, MPH
Secretary to the National AIDS Commission
Presented at UN RTF ICAAP SYMPOSIA
Issues:
Twin epidemic of drugs and AIDS:
o IDU driven, almost all provinces are reporting
a growing drug user community
Issues:
Criminalization of drug users
 Prohibitive drug laws 5 and 22/1997
 Drug users are a covert & underground community,
unprotected by the public system, isolated from
society
 Prisons are filled with young drug users, increasing
vulnerability to HIV, Hep C, sexual abuse, etc
 No access to health care  fear of arrest + stigma &
discrimination from health providers
The journey towards partnership
o [1999- 2006] drug users as a community not recognized by
government; programs very little consultation; drug
users mere projects’ targets not involved in any form of
planning;
o Presidential Regulation75 /2006 about Nat. AIDS Comm
Civil society rep. : equal members of the Commission
Drug users, PLHIV, sex workers, academics, etc. all
active & participating members in policy making
meetings
The journey towards partnership
o Coord Min for People’s Welfare/ Chair NAC: reg
2/2007: “harm reduction” = public policy for HIV
prev and care for people who inject drugs IDUs
NOT criminals , they have Human Rights
 Then there was the drug users movement:
- local communities organized themselves
- a national network was established (2007)
- consistently providing inputs to ensure the public
health system accommodates drug users needs
It took the realization from both parties,
government and civil society:
The government…
o drug users = citizens, protected from human
rights violation, violence, abuse and any form of
discrimination
o drug users (in and out of prisons) are not denied
their human rights, including the right to life,
education, health care etc
It took the realization from both parties,
government and civil society:
Civil society…
o
educated itself concerning civic rights and obligations
o
became contributing members of society, monitors the
running of the public ‘engine’: social, economic, legal,
health, etc
o
Learned to become an agent of change when system
doesn’t accommodate their needs
Indonesian drug users communities actively
involved in policy making processes
from national to the local levels
o
Org & financial support to the National Drug Users
Network, incl Drug Users Congress 2007 & 2009
o
NAC established: (WG) gender & human rights 
all elements of civil society: legal aid, human rights
group, women’s movement groups, etc.
o
HR WG all levels: Aids Comm, Health, Police, Narc
Board, CSO, Org Drug victims, prison officials, etc
 for planning, coordination, M&E
o
Together: Govt, CSO, drug users, PLHIV networks,
support efforts for drug law reform
Combining forces to scale up….
o The government’s commitment
and support to universal access
for prevention and care:
o  domestic resources : e.g.
Jakarta supports all public
health centres for NSP and
some including MMT,
Pontianak, Mataram, etc
o Increasing coverage,
particularly among drug users
(+ IPF, GFATM, AUSAID)
NSP until Dec 2008
200
182
180
160
147
140
120
120
113
100
79
80
65
69
60
68
55
40
20
4
0
4
0
2002
4
4
0
2003
Total NEP
Source: NAC
17
10
11
1
2004
10
7
2005
2006
NEP at Primary Health Care
2007
2008
NEP at NGOs
MMT – Dec 2008
40
35
35
30
25
24
20
17
15
11
6
9
5
0
14
11
10
02
02
02
03
2
0
2002
2
0
2003
2
0
2004
21
2005
Source: NAC
at hospital
at PHC
4
4
4
1
2006
2007
Dec 2008
at Prison
TOTAL
The trust of the people in the leaders reflects
the confidence of the leaders in the people.
Paulo Freire
Terima kasih
Thank you