Strengthening Indonesia’s Health System Key to HIV Elimination by 2030
Research from the BRIN Agency for Public Health and Nutrition Research Center underscores the urgent need to bolster Indonesia’s health system for successful HIV elimination by 2030.
During a recent Webinar, researcher Mirna Widiyanti outlined several critical issues that require immediate attention.
Enhancing Laboratory Capacity and ARV Drug Accessibility
Widiyanti stressed the importance of increasing laboratory capacity for HIV viral load testing and genetic resistance analysis. Currently, 301 rapid molecular tests and 42 testing facilities utilizing Abbott branded devices for viral load measurements are available.
Ensuring the equal distribution of antiretroviral drugs (ARVs) is also crucial. Widiyanti emphasized that a well-structured distribution system is essential which guarantees ARVs are accessible in all health facilities, especially those in remote locations.
Currently, only four laboratories – Dharmais Cancer Hospital in Jakarta, RSHS Bandung, Soetomo RSU Surabaya, and the Papua Health Laboratory Center (BLK) – offer early infant diagnosis (EID) or molecular examination for babies born to HIV-positive mothers. This limited availability highlights a pressing need for expansion.
Scaling up Treatment Facilities and Healthcare Workforce Training
The network of HIV counseling and testing facilities comprises 12,495 units, while 5,341 units provide ARV treatment services. Widiyanti recommends increasing the number of these critical facilities, especially care, support, and treatment (PDP) services.
Addressing the demand for skilled healthcare professionals is another key area of focus. Widiyanti advocates for comprehensive training programs for healthcare workers on managing ARV resistance and implementing the latest treatment regimens.
Forging International and National Partnerships
Widiyanti stressed the need for both strengthening national collaborations with stakeholders and fostering international partnerships with organizations like UNAIDS and WHO. This concerted effort ensures Indonesian policies regarding ARV management align with global standards.
Targeting Zero Stigma
The overarching goal is to achieve a ‘three-zero’ target by 2030: zero new HIV infections, zero HIV-related deaths, and zero discrimination against people living with HIV (PLWHA). Vital to reaching these ambitious targets is a comprehensive strategy to eliminate the stigma surrounding HIV/AIDS.
Widiyanti highlighted the pervasive public misconception regarding HIV transmission. She emphasized that the virus cannot be transmitted through everyday activities like sharing meals, swimming together, or using the same restroom. HIV can only be transmitted through blood, sexual intercourse, the use of non-sterile syringes, and from mother to child during pregnancy, childbirth, or breastfeeding.
Zero stigma by 2030 is the clear objective
The researcher
expressed strong belief that by 2024, stigma levels should start to decline significantly Allyur predicted that stigma against PLWHA will be eradicated by 2030.
UNAIDS has established a global 95-95-95 strategy for HIV elimination: 95% of individuals with HIV knowing their status, 95% receiving ARV treatment, and 95% of those on treatment having a suppressed viral load. The Indonesian government is deeply committed to achieving these targets.
* What specific training and capacity-building programs are needed to ensure that Indonesia’s healthcare workforce is adequately equipped to provide high-quality HIV care?
## Strengthening Indonesia’s Health System for HIV Elimination: An Interview with Mirna Widiyanti
**Host:** Welcome back to the show. Today, we’re discussing a critical topic – HIV elimination in Indonesia by 2030. Joining us is researcher Mirna Widiyanti from the BRIN Agency for Public Health and Nutrition Research Center. Thank you for being with us, Mirna.
**Mirna Widiyanti:** It’s a pleasure to be here.
**Host:** Your recent research highlights some significant challenges facing Indonesia in its pursuit of eliminating HIV. Can you elaborate on some of these key issues?
**Mirna Widiyanti:** Certainly. Our research shows that bolstering Indonesia’s health system is paramount for achieving our goal of eliminating HIV by 2030. One immediate concern is the need to **enhance laboratory capacity**. We require increased access to HIV viral load testing and genetic resistance analysis. Currently, we only have a limited number of testing facilities and available rapid molecular tests. This capacity gap hinders our ability to effectively monitor treatment progress and identify emerging drug resistance [[1](https://crossroads.unaids.org/story/indonesia/)].
**Host:** You also mentioned the issue of ARV drug accessibility.
**Mirna Widiyanti:** That’s right. Ensuring equitable distribution of **antiretroviral drugs** (ARVs) is crucial. We need a robust distribution system guaranteeing access to ARVs in all health facilities, particularly in remote areas. This is vital for ensuring that everyone living with HIV can access life-saving treatment [[1](https://crossroads.unaids.org/story/indonesia/)].
**Host:** Beyond laboratory capacity and drug accessibility, what other areas need attention?
**Mirna Widiyanti:** We must **expand our network of treatment facilities**. While we have a considerable number of HIV counseling and testing units, we need to increase the availability of ARV treatment services and particularly care, support, and treatment (PDP) services. Furthermore, investing in **training and capacity building for our healthcare workforce** is essential to meet the growing demand for skilled professionals dedicated to HIV care.
**Host:** These are indeed significant challenges. Thank you, Mirna, for shedding light on these critical issues. I hope that these insights will encourage further action and collaboration to strengthen Indonesia’s health system and ultimately achieve the goal of HIV elimination.
