Jakarta, September 6 – Another form of emergency has quietly emerged in Indonesia from the COVID-19 pandemic, and it’s rooted in stigma and discrimination against people living with HIV/AIDS (PLHIV), and a disruption in accessing the life-saving anti-retroviral treatments (ARV).

The challenge has been more pronounced among the women’s communities who had already faced with unequal access to ARV. As the lockdown hampered the ARV supply chain, much of the women’s communities living HIV and AIDS are now in even more perilous situation.

These are some of the key takeaways from a recent public health webinar hosted by UNDP, in collaboration with the Ministry of Health, Australia’s Department of Foreign Affairs and Trade (DFAT) and - UNAIDS - Unified Budget, Results and Accountability Framework (UNAIDS-UBRAF). The webinar aims to build a strategy in achieving the three Zero vision: zero new HIV infections, zero discrimination and zero AIDS in addressing the HIV amid the pandemic.  

The webinar also looks at the way the country can achieve its 90-90-90 targets . The target aims to ensure that 90 percent of all people living with HIV will know their status, 90 percent of all people with diagnosed HIV receive sustained antiretroviral therapy and 90 percent of all people receiving antiretroviral therapy will have viral suppression.

“Reflecting on the past three  decades in handling HIV/AIDS and response, treatment can only be effective if we address inequality and ensure full protection of human rights - especially for women, youth and key populations.” Said Rachel Arini Gender Consultant from UNDP Indonesia adding that a gender transformative approach could ensure wider accessibility for everyone as Indonesia works towards its 90-90-90 targets.

Entitled “Improving Access to Treatment and Gender Transformative Approaches in Combating HIV During the Pandemic in Indonesia”, the webinar discussed two areas of the  HIV treatment supply chain in Indonesia. These included human rights and gender assessment on HIV/AIDS policies in Indonesia and the role of e-citizen platform SP4N-LAPOR! (Sistem Pengelolaan Pengaduan Pelayanan Publik Nasional-Layanan Aspirasi dan Pengaduan Online Rakyat) - National Public Service Complaints Handling System to address the issue.

Other keynote speakers included Mr. Aaron Watson from DFAT and dr. Siti Nadia Tarmizi from the Ministry of Health - Director of Disease Prevention and Control who expressed their encouragement to achieve the three zero target on HIV treatment in Indonesia. The optimism highlighted the importance of collective effort in meeting the targets and to ensure no one is left behind.

Supply chains in Indonesia, a vast archipelagic country with 17-thousand islands, are critical to the success of equal provision of the ARV. A recent UNDP assessment on the HIV supply chain in Indonesia during the pandemic found that the country was not close to  achieving its 90-90-90 targets.

“As of 2020, only 6.1 percent of PLHIV have receiveed ART with viral suppression, which categorizes Indonesia as a high HIV burden country. Regarding the provision of ARV, export costs are predicted to increase by 10%-25 percent,.”said Maura Linda Sintanggang, senior UNDP Consultant for Pharmaceutical Supply Chain Management.

The restriction on travel has also weakened ARV stock management and distribution with overstocks being reported at several areas. Recommendations included a centralised system between provinces and the national government to create manage information system on ARV stocks within the supply chain. Furthermore, the SIHA 2.0, a one-stop information platform on HIV/AIDS managed by the Health Ministry, needs to be enhanced to provide accurate real-time data on stocks  with an early warning system indicator.  Lastly, there needs to be an integrated solution for logistics management.

Digital technology could help enhance these efforts. Monica Amy Nabella,an Analyst with the Ministry of Administrative and Bureaucratic Reform addressed the country’s SP4N-LAPOR! platform which has, so far, seen more people addressing their civic concerns. This technology could also be used by vulnerable populations seeking greater access to critical supplies.

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Written by Nadine Hassan

Edited by Ranjit Jose and Suryo Tomi