Denpasar, On late Friday afternoon, September 9th, Yakeba’s office in Denpasar suddenly filled with people. Thai Media reporters accompanied by representatives of the Thai Department of Disease Control and members of the local (Balinese) health department flocked into the meeting room and set up their equipment for the following presentation. Their visit at Yakeba was part of a trip to Indonesia in order to see the archipelago’s efforts in harm reduction related to injecting drug use (IDU). Harm reduction aims at reducing the social, health and economic harms associated with drug use and drug policies, with a special focus on the prevention of HIV and AIDS.
After a short introduction, Adi Mantara, director of Yakeba, presented a slide show about Yakeba and its experience and success with harm reduction for injecting drug users. A couple of years ago Yakeba has gained a region-wide reputation for its successful harm reduction program directed at the local IDU community. Through Yakeba’s comprehensive harm reduction program IDUs were provided with accurate information regarding HIV and AIDS, information on using drugs safely, sterile injecting equipment (including new needles, alcohol swabs and bleaching kits), free condoms and referral information on Methadone and VCT clinics. Yakeba has also been actively engaged in promoting human rights for people affected by drug addiction and HIV and AIDS. Activism led to the establishment of a daughter organization named IKON Bali, an organization of former drug users fighting for equal rights and a more human treatment of drug addicts and people living with HIV and AIDS.
Another front of harm reduction work in Bali and other parts of Indonesia is the work in prisons. Some prisons have adopted harm reduction strategies and could successfully lower the spread of HIV among their inmates. Indonesia was the first country in Asia providing harm reduction inside the prison system.
In Thailand, harm reductionists and Human Rights activists are currently lobbying the Ministry of Public Health for greater leadership and cooperation concerning the nations harm reduction strategy. While Thailand has been successful in greatly reducing the spread of HIV among sex workers and their clients, HIV transmission among IDU’s has remained largely unrestricted. This is believed to be a result of the governments reluctance to seriously implement harm reduction for IDUs as well as the governments criminal justice approach when it comes to drugs. In the year 2003, under the former Prime Minister Thaksin Shinawatra, a bloody “war on drugs” was initiated, which cost the life of more than 2500 people thought to be associated with the drug trade. Thaksin’s “war on drug” was highly criticized by Human Rights activists from around the world. Today, activists call for a greater involvement of (former) IDUs in harm reduction policy development and programming and the abolition of repressive laws and policies which rather increase the negative impacts of drug use than minimizing it.
At the end of the presentation there was enough time for the visitors to ask questions and the Thai Media reporters seized the chance to interview Adi Mantara and some of the present staff of Yakeba.
Harm reduction programs like the one from Yakeba could successfully slow the spread of HIV among IDUs on the island of Bali and in other regions across Indonesia. Nevertheless, prevalence rates among IDUs are still unacceptably high. Thus harm reduction should still be a priority, not only for the sake of IDUs but also for the sake of society at large.
By Felix Neuenschwander