By Virgi Fatmawati

HIV/AIDS remains a major global public health issue, having claimed 40.4 million lives so far. In 2022, the WHO reported that 630,000 people died from HIV-related causes globally. Approximately 39 million people were living with HIV at the end of 2022, with 1.3 million people becoming newly infected with HIV. Countries need to sustain HIV programmes, specifically in the context of universal health coverage and national strategy to reduce HIV morbidity and mortality and end AIDS epidemic by 2030.

However, Indonesia is still lagging in reaching the global 95-95-95 targets where by 2025 at least 95% of people living with HIV (PLHIV) should know their HIV status, 95% of PLHIV who know their status should be receiving antiretroviral therapy (ART), and 95% of PLHIV receiving ART should have suppressed viral loads. Indonesia’s achievement on the first, second, and third targets were 81%, 41%, and 19% respectively per December 2022. The Ministry of Health estimated that the current number of people living with the HIV (PLHIV) in Indonesia is 543,100, and only 41% of them are on ARV (antiretroviral) treatment.

For the PLHIV, lack of access to adequate medical treatment has been hindering the progress for patients. Adherence to ARV treatment is not always a simple thing to do for most PLHIV because they must take the medication every day for the rest of their life. “I have been taking care of my HIV-positive son for sixteen years. It is indeed a bittersweet feeling. Yet, I am grateful that my son is still able to lead a normal life and even work professionally. We find it quite challenging when it comes to the ARV treatment. Sometimes, we must go back and forth to the Community Health Center (Puskesmas) to get ARVs when the medicine stocks are running low. Hopefully this doesn't happen again in the future." said Heni, a 72-year-old mother of a millennial PLHIV. She also shared that family support is crucial to motivating PLHIV to take routine medication.

UNDP partners with the Ministry of Health and The Global Fund to strengthen the supply chain management of drugs and logistics needed for HIV/AIDS prevention, testing, and treatment. The Sistem Monitoring Imunisasi dan Logistik secara Elektronik (SMILE) enables pharmacists and HIV program staff nationwide to digitally monitor the real-time visibility of HIV drugs and logistics, track batch and expiry dates, and prevent stockouts and unnecessary disposals.

“SMILE Logistics is a useful app. We can timely monitor drugs and medical supplies for HIV treatment and be more aware when they are nearly expired or out of stock because the app also notifies us through SMS and e-mail. With a manual record system, sometimes we overlook the drugs’ expiry dates even though we already put a sign on their packages or list them down on the stock cards." said Sani Nur Baeti, Pharmacy staff at Gedong Tengen Community Health Center, Yogyakarta.

The SMILE Logistics application was piloted last October 2023 in Yogyakarta prior to the nationwide scale-up. Through hands-on training and the deployment of this app, 82 staff (90% are women) of the Yogyakarta Provincial and City Health Offices and 18 Puskesmas are now better equipped with an improved health information system. As of November 2023, the SMILE Logistics app has recorded 866 transactions which include 1.5 million tablets of ARV and 20,290 rapid test kits for HIV and Sexually Transmitted Infections (STIs). Expanding the SMILE logistics monitoring system across Indonesia will help the Ministry of Health better manage HIV/AIDS drugs and logistics to the last mile.

This World AIDS Day commemoration is a reflection on how far our fight is to end AIDS. This theme "Let Communities Lead" resonates with the spirit of the global movement that eradicating AIDS by 2030 is possible only if all parties: communities on the frontlines, starting from PLHIV, families, and health workers, are involved and get the full support they need. UNDP and its partners emphasize the resonance unwavering efforts on reducing HIV morbidity and mortality and end the AIDS epidemic. This effort also highlights reducing inequalities through gender-transformative programming to transform more gender-equitable and human rights-respecting communities.

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