Covid-19 is not the only pandemic that must end: Jakarta Post contributors

JAKARTA (THE JAKARTA POST/ASIA NEWS NETWORK) – In the past two years, not a day has gone by that we don’t think about our health and well-being.

Health has been the topic of conversation among families, friends, colleagues, as well as the subject of headlines in all the global and national media. In fact, two years after the Covid-19 pandemic, global attention is focused more than ever on healthcare.

The same can be said of the Indonesian government, whose commitment to health can be seen from the strong response to the pandemic to the prioritization of global health infrastructure in the presidency of the Group of 20 (G20). Despite facing massive hurdles since the first cases of Covid-19 in March 2020, Indonesia has now seen a largely successful pandemic response, with rates of infections, hospitalizations and deaths steadily declining.

At the same time, President Joko “Jokowi” Widodo continues to express his aspiration and drive for Indonesia to be a hub for vaccine production in the region. The success of the Covid-19 response and Indonesia’s vision as a leader in pandemic preparedness is highly commendable. But it still leaves a lot to be desired, especially as most of the attention revolves around the Covid-19 pandemic.

AIDS is not over, but it can be. With the government’s dedicated attention and commitment to health care and pandemic preparedness, we must not forget the public health threats that still exist, such as AIDS and Tuberculosis (TB).

Less than a decade from 2030, when both epidemics are set to end, we see too many preventable deaths still occurring from these diseases. In Indonesia alone, 24,000 people lost their lives in 2020 due to AIDS-related illnesses, despite the fact that AIDS is preventable with antiretroviral treatment.

This is a consequence of the low treatment coverage of only 26 per cent of people living with HIV on treatment in Indonesia, which is one of the lowest rates in the world, higher only than that of South Sudan (23 per cent), Madagascar (14 per cent). percent), Pakistan (12 percent), and Afghanistan (9 percent), according to 2020 UNAIDS estimates.

Globally, HIV disproportionately affects populations that are often marginalized, criminalized and subject to stigma and discrimination, including men who have sex with men, transgender women, sex workers and people who use drugs. Many women living with HIV and children living with HIV often experience a similar situation.

Harmful gender and social norms, as well as legal barriers, greatly hamper the response to HIV, as highly affected communities fear accessing services. Studies have shown that people living with HIV who perceive high levels of HIV-related stigma are 2.4 times more likely to delay enrolling in care until they are very ill.

Despite the challenges, we have the tools to end the epidemic in the Global AIDS Strategy 2021-2026. The Global AIDS Strategy provides the world with the main priority areas and actions to end AIDS, namely ensuring equitable access to services for all, especially those at risk; breaking down social and legal barriers to HIV, such as decriminalizing key populations; and ensuring a fully funded and sustainable response to HIV.

The strategy also emphasizes the need to end the inequalities that still drive the epidemic and keep us from universal health coverage. The principle of universal health coverage is guided by the notion that affordable, accessible and high-quality health care should not be the privilege of a few, but of all.

Indonesia has shown its ability to uphold this principle in the response to Covid-19. Vaccines against covid-19, for example, have been distributed and administered equally to Indonesians throughout the country, without discrimination.

Furthermore, even the majority of people living with HIV, who are at increased risk of severe or fatal Covid-19 infection, have been able to access Covid-19 vaccines as have other populations, according to a survey by Jaringan Indonesia Positif.

However, outside of Covid-19, universal health coverage is not yet a reality. Key populations at risk of HIV are falling behind in universal health coverage according to a review recently published by UNAIDS Asia Pacific that focused on six countries in the region: Cambodia, India, Indonesia, the Philippines, Thailand and Vietnam. Barriers to enrollment, such as lack of awareness of eligibility and unfulfilled administrative requirements and decriminalization, prevent some people living with HIV and key populations from benefiting from health insurance in Indonesia.

Indonesia’s national insurance scheme, like that of neighboring countries, does not comprehensively cover HIV prevention services, leaving community organizations to play an important role in filling these gaps for the unprotected financial.

Unlike covid-19 vaccines, HIV prevention is not a priority. The absence of HIV prevention as a national priority has meant that rates of new HIV infections are not declining fast enough. In 2020, there were an estimated 28,000 new HIV infections in Indonesia, 46% of which occurred among 15-24 year olds.

Inaction in the face of the AIDS epidemic has come at a high price. Indonesia’s bold actions and commitments against Covid-19 cannot stop there. In 2021, Indonesia, as a UN member state, adopted the Political Declaration to End AIDS, committing to meet global goals and address the inequalities that drive the epidemic.

Indeed, global targets are being adopted at the national level, based on the government’s forthcoming Multisectoral Strategic Action Plan on HIV. As the world marks World Health Day on April 7, we send an urgent reminder that Covid-19 is not the only pandemic that must end. For Indonesia’s vision of being a pioneer in global health to become a reality, vulnerable communities and existing threats to public health cannot be forgotten.

So when we think about health, let’s not just think about Covid-19. Refocus attention on HIV and AIDS, and we can successfully end inequalities, end AIDS, and end pandemics for a healthier tomorrow.

  • Krittayawan Boonto is the UNAIDS Country Director for Indonesia. Tjandra Yoga Aditama is the Graduate Director at YARSI University and Professor of Pulmonology and Respiratory Medicine at the University of Indonesia. Meirinda Sebayang is the President of the National Secretariat of Jaringan Indonesia Positif. The Jakarta Post is a member of The Straits Times’ media partner, Asia News Network, an alliance of 23 media organisations.

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