Interview with Nafsiah Mboi ,
Yuli Ismartono [time 29:29]
Yuli Ismartono: Thank you for being in our program.
Nafsiah Mboi :
YI: How did you become interested in the problem of HIV/AIDS?
Nafsiah Mboi : It was not my first choice. I am a pediatrician and I was at Harvard University in 1987, where I was pursuing my real interest in public health. There I had the honor and the opportunity to meet Jonathan Mann who had just moved from the World Health Organization to Harvard and we became very good friends. He used to warn me: "If you don't do anything in Asia, remember, Asia will be the next time bomb. If HIV is loose in Asia, Africa will be nothing." I always remember that. So, as soon as I came back from Harvard, I established a group of doctors who agreed that we had to do something.
YI: Indonesia is one country in Asia with a serious problem of HIV/AIDS. How serious is the problem actually?
Nafsiah Mboi : We certainly take it seriously. At the national level, it is low, a prevalence of less than one percent. But, what I see is that in certain types of population, we see a prevalence of over 50 percent, among prisoners, sex workers, we have five to 15 percent, also men having sex with men and trans-genders. So, definitely, that is a warning. And in some provinces like Papua and East Java and Sumatra, we are already see HIV infections among housewives and babies. So that is a real indicator for us that we have to take it seriously. And it is a serious problem.
YI: In terms of numbers, how many people in Indonesia are at risk?
Nafsiah Mboi : The largest number, about 9 to 12 million people in Indonesia are at risk because they are either prostitutes or sex workers or their partners. For instance for sex workers, male, female as well as trans-genders, the number of their clients is estimated to be between 3 and 6 million. That's a huge number. Injecting drug users are about 200,000 and men having sex with men number about 700,000. So, this all adds up because we are a big population. We don't want to have it so big that we cannot do anything anymore. We believe we still have a small window of opportunity to keep it under control by accelerating prevention.
YI: Is the problem the same in all the provinces, or is one province worse off than the other? We heard about Papua, about migrant workers in West Nusa Tenggara, for instance, who are at risk.
Nafsiah Mboi : No, it is not evenly distributed because we are an archipelago and indeed, it is one of our challenges that we have to provide services to all these islands, including the most remote islands. We now have the reports from 214 districts from 32 provinces, but still, very little is reported. The numbers that are reported are only 22,000 up till now. But actually, according to our estimates, we have over 200,000 already infected. So, if you talk about the tip of the iceberg, only about 10 percent have been identified and diagnosed as HIV positive. And indeed, the prevalence is not the same. We have the highest prevalence as of 31st December 2008 in West Java, DKI Jakarta (Jakarta Metropolitan Area), East Java and Papua. Papua does have the highest prevalence case rate, which is the number of HIV positive per 100,000 adult population. And because Papua and West Papua, the two provinces on the whole Papua island, the number of people living there is so small - only about 3 million or about 1.7 million adult population - then the numbers indeed looks very grave. The case rate is very high.