Beyond MDGs: Indonesia’s Role as Middle Income Country in Addressing HIV and Sexual and Reproductive Health and Rights
Jakarta, 21 May 2012 – Despite some notable achievements in meeting the Millennium Development Goals (MDGs) targets, Indonesia faces a huge challenge in achieving the MDG 5 i.e., reducing maternal mortality ratio (MMR) and achieving universal access to reproductive health, and to the MDG 6, i.e., reversing the spread of HIV/AIDS. The latest data from Indonesia Demographic and Health Survey (IDHS/SDKI) shows that the country’s MMR reached 228 per 100,000 live births, which is among the highest in Southeast Asia. Various challenges related to universal access to reproductive health have been hampering our human development. In addition, according to the 2009 national estimates of HIV infection, about 186,257 people were infected with HIV. In a mathematic model of the HIV epidemic in Indonesia, the Ministry of Health projected that without an acceleration of prevention, 541,700 people will be HIV- positive by 2014.
“Notwithstanding our other achievements, the MDGs 5 and 6 are indeed huge challenges that we need to address in order to meet all the MDG targets by 2015, said Prof. Dr. dr. Nila Moeloek, SpM (K), the Indonesian President’s Special Envoy on the MDGs during a seminar on ‘Beyond MDGs: Indonesia’s Role as Middle Income Country in Addressing HIV and Sexual and Reproductive Health and Rights’ held jointly by the Office of the President’s Special Envoy on MDGs , the Faculty of Medicine of the University of Indonesia, UNAIDS and UNFPA. The seminar was held in conjunction with the visit of Special Adviser to the UN Secretary General and his Special Envoy on HIV/AIDS in Asia and Pacific, Dr. Nafis Sadik, to Indonesia.
Prof. Dr.dr.Nila Moeloek, SpM (K) said that Indonesia is a signatory and has adopted the Cairo’s International Conference on Population and Development (ICPD) Programme of Action that aims to set up a new paradigm in reproductive health, putting human rights, human development and individual well-being at the center of programme policies. This move is strengthened by the signing of Declaration of Millennium Development Goals in 2000 which, among others, focus on reducing the maternal and infant mortality and combating HIV/AIDS and other communicable diseases. Indonesia is also committed to the 2011 High Level Meeting on HIV goal of ‘Getting to Zero: Zero New HIV Infections, Zero AIDS-related Deaths, and Zero Discrimination against people living with HIV, and key affected populations.’
“The adoption of these three international agreements by the Government of Indonesia shows our strong commitment as well as country milestone in creating a framework to address sexual and reproductive health and rights in the country. Failing to solve problems surrounding reproductive and sexual rights means that we fail to meet the MDG targets as well as translate our promise in Cairo into actions,” said Prof. Dr.dr.Nila Moeloek, SpM (K).
Dr. Nafis Sadik, who is also the former Under Secretary General and Executive Director of the United Nations Population Fund (UNFPA), and one of the architects of Cairo Conference, said that unfortunately, the many promises on sexual and reproductive health made in Cairo Conference have not been translated into action. “After the ICPD, the issue of gender equality showed some progress but there were still some challenges that still had to be quickly overcome.
When it comes to sexual and reproductive health rights, especially for women and girls, the situation becomes more complex,” she said, adding that issues of unmet needs in family planning that leads to unintended pregnancies and unsafe abortion continues to be a real problem globally. She also noted that stigma and discrimination against people living with HIV, and groups such as sex workers, drug users, men who have sex with men, and waria (transgenders) continue to limit the effectiveness of HIV prevention, treatment, care and support efforts. She also noted that Indonesia has a comparatively low level of action on prevention of HIV transmission from mother to child, with only 5% of positive pregnant women receiving the treatment needed to prevent HIV in their babies. Having a long involvement with reproductive and sexual health issues including among young people, Dr. Nafis Sadik said that Indonesia shared the worrying trend of increasing HIV prevalence among youth with its neighbor in Asia and the Pacific.
In Indonesia, unmet needs in family planning show a stagnant figure at 9% and spread of HIV especially among young people has been worrying trend. Indonesia has around 65 million young people aged 10-24 year-old or approximately 28% of the country’s total population of 237 million. Without access to sexuality education and reproductive health services, adolescents and young people, especially girls, face daunting challenges of sexually transmitted infections including HIV, violence, exploitation, unwanted pregnancies, unsafe abortions and maternal mortality.
Dr. Nafsiah Mboi, SpA, MPH of the National AIDS Commission (KPAI/Komisi Penanggulangan Aids Indonesia) said that young people aged 15-29 are the most at risk group to the spread of HIV. She cited the latest Country Report on the Follow Up to the Declaration of Commitment on HIV/AIDS recently released by National AIDS Commission (KPAI) and UNAIDS this month indicated that the dominant mode of transmission of HIV infection at this time in Indonesia is through unprotected sex particularly among people with a high numbers of partners. “The HIV epidemic has shifted; in the past, most new infections came through injecting drug use. Now, the majority of new infections come through sexual transmission,” she said, noting that adjustments in the national strategy are needed.
These various sexual and reproductive health issues have become a basic health problem in Indonesia that hamper the accomplishment of Indonesian community welfare by the target year of 2015. Prof. Dr. dr. Nila Moeloek, SpM (K) added that, “Despite the relatively-high maternal and infant mortality rates, as well as increase in HIV/AIDS infection, KUKPRI MDGs stays optimistic since there are lots of people who are doing their jobs in overcoming the problems in sexual and reproductive health issues among their surrounding communities on their own initiatives. These sporadic efforts will be gradually shifted into an integrated primary health service model that later can be adopted in other areas of Indonesia.”
"Moving beyond 2015, we need to keep in mind that globally, we are moving toward sustainable development framework, where social, environment and economic aspects are the three main pillars. Integration between those key areas as well as harmonization and integration across sectors with involvement from multiple stakeholders will be the main drivers to minimize the still existing disparities in Indonesia," said Prof. Dr.dr.Nila Moeloek,SpM (K).
At the moment, KUKPRI-MDGs has just formed a model program called ‘Pencerah Nusantara’ that focuses on strengthening primary health services for Indonesian people. “Pencerah Nusantara team consists of a group of young people with varied professions, such as general practitioners, dentists, nurses, midwives, and other health representatives, who will join in a collaborative action to help resolve the community’s health problems. These young people will be assigned in the Indonesian remote areas to strengthen the primary health services for a period of one year,” added Prof. Dr. dr. Nila Moeloek, SpM (K).
Through this seminar, all related parties, including UNFPA, UNAIDS and FMUI, would like to invite all medical students as the future medical resources to be the agent of change that will care and devote themselves to providing primary health services to Indonesian people most in need. “One small sincere action for the country is a milestone in creating healthier and prosperous Indonesia,” ended Prof. Dr. dr. Nila Moeloek, SpM (K).
About KUKPRI-MDGs
Based on the President Instruction No. 3 year 2010, it stated that the role of President’s Special Envoy Republic of Indonesia for MDGs is to provide assistance in strengthening and holds the efforts given from the respective ministries (Health, Finance, Education and Environment); which compulsory to insert MDGs under the ministries’ programs and also to represent President Republic of Indonesia in the international and national scale forums.
The objective of President’s Special Envoy Republic of Indonesia (KUKPRI) to assist Special Envoy to facilitate communication activity between the cross section ministries at the local level and also as being the catalyst needed among stakeholders. To conducts its tasks given upon the mandate of the President, Special Envoy on MDGs will form small but yet effective organization filled with senior professionals and volunteers from academy, private sectors, NGO’s, profession organization and donor community.
About UNFPA
UNFPA is an international development agency that promotes the rights of every woman, man and child to enjoy a life, health and equal opportunity. UNFPA supports countries in using population data for policies and programmes to reduce poverty and to ensure that every pregnancy is wanted, every birth is save, every young person is free from HIV and every girl and woman is treated with dignity and respect. UNFPA began its partnership with Indonesia in 1971 and today has become one of Indonesia’s most important partners in addressing reproductive health, gender, and population issues.
About UNAIDS
UNAIDS is the Joint United Nations Programme on HIV/AIDS. UNAIDS was established in 1996, and aims to support countries to have an expanded national response to their HIV epidemics. UNAIDS is composed of eleven co-sponsor UN agencies: UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, ILO, UNESCO, WHO, the World Bank, and UN Women. Internationally, UNAIDS advocates for universal access for prevention, treatment, care and support on HIV. In 2011, the UN High Level Meeting established three main targets on “Getting to Zero”: Zero new infections; Zero AIDS-Related deaths; and Zero Discrimination against People Living with HIV and key affected populations. In Indonesia, the UNAIDS Secretariat has focused on resource mobilization, advocacy for human rights based approaches to HIV, and supporting dialogue with faith based organizations.
For further information:
Agustina Wayansari
Communication Officer
UNFPA Indonesia
Menara Thamrin 7th Floor
Jl. MH Thamrin Kav. 3
Jakarta Pusat
Telp. 314 1308 / 0812 1068341
Email: wayansari@unfpa.org
Tags: Reproductive Health, HIV/AIDS, Millennium Development Goals
