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"Methadone in prison to launch in Bali" by Irene Lorete, Asian Harm Reduction Network - Indonesia

9th December 2004

Last week, a training on methadone substitution - for both hospital and prison setting - began in Bali. It is the first of two such trainings to take place in Indonesia and is being supported by the Family Health International's Aksi Stop AIDS Program (FHI-ASA), the World Health Organization and the Indonesian HIV/AIDS Prevention Program (IHPCP).

The training will conclude with the national launch of the methadone program at the Kerobokan Prison in Bali on the 10th of December.

The introduction of methadone in the penal system is an incredible step taken by the Indonesian government, proving that substitution therapies are not incompatible with policy in the world's most populous Muslim country.

It took nearly two years before they totally warmed up to needle and syringe exchange and methadone substitution - harm reduction interventions, which, despite evidences that they are effective in preventing HIV transmission from injecting drug use, are still the least practiced and funded.

"We have worked very hard to convince the Indonesian government to introduce methadone in prisons here and have had some remarkable success," shares Palani Narayanan, IHPCP's Technical Adviser for Harm Reduction.

"This was not an option two years ago but through targeted advocacy, we have managed to convince policy makers, and this includes making methadone a component of treatment for prisoners in the national guideline.

"The government has been moving in the right direction," adds Palani whose advocacy strategy for IHPCP has lead to this track. The plan included study tours of prison methadone programs in Iran and New South Wales, choosing the right people to go, and ensuring that follow-up discussions happen when they returned.

The implementation of methadone substitution in Bali and Jakarta prisons is yet another milestone in harm reduction in Indonesia following the signing of a Memorandum of Understanding in December 2003 between the National Police and Social Welfare Ministries (on behalf of the National Narcotics Bureau/BNN and the National AIDS Commission/KPA, respectively) to effectively address HIV/AIDS and drug use.

The aim was to integrate efforts to control HIV among IDUs and establish a National Harm Reduction Implementation Team to facilitate multi-sectoral coordination. 

Then in a public meeting hosted by the National AIDS Commission in July, the acting Minister for People's Welfare and the Head of the National Narcotics Board launched the plan to pilot harm reduction programs, including NSP, in preventing the spread of HIV from injecting drug use.

The pilot project will run for three years in Jakarta and Bali and is expected to reach 10,000 users per year. To date, NGOs running NSPs long before the launch of the government-sponsored program have reached 3,000 injecting drug users.

Contact Palani Narayanan at email: pnarayanan@ihpcp.or.id

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