Aty Uleng, Fellow, IDPC Asia Regional Fellowship Programme, Makassar, Indonesia
Emily Rowe, Harm Reduction International, Bali, Indonesia
Historically, drug use in Makassar was concentrated among injecting drug use communities, but owing to the increasing scarcity of heroin and the accessibility of methamphetamines (an amphetamine-type stimulant (ATS)) in the area, drug use trends are shifting. Makassar is a port city located in the geographically strategic eastern part of the Indonesian archipelago. Narcotics and precursors enter via the harbor and then are distributed to other parts of Indonesia. Makassar could be considered a pioneer in harm reduction, however in the past several years owing to a decline in international aid, harm reduction is no longer considered a priority area, fallen wayside to other pressing health, legal and social concerns. Nevertheless, Makassar has the 5th largest HIV burden in the island nation, 60% of which identify as people who use drugs.
In order to revitalize harm reduction work in the city, Aty Uleng Hamid, a Fellow under IDPC’s Asia Regional Fellowship Programme 2017 – 2018 (RFP), brought together stakeholders and harm reduction advocates to draft a more responsive harm reduction local level policy that is more reflective of current drug use trends. Previous work on harm reduction concentrated on injecting drug use, and the running of a well-established needle/syringe programme (NSP), methadone maintenance treatment (MMT) and recovery programmes, however stakeholders have yet to respond to the growing ATS issue. In Makassar, ATS use is to be found among all sectors of society and the correlation between HIV incidence via sexual transmission and ATS is increasingly acknowledged by healthcare providers and policy makers.
The level of commitment and atmosphere of collaboration demonstrated by the cross-sectoral participants was tangible. The workshop highlighted the fact that a local policy addressing Harm Reduction and HIV services (including human rights aspects and service equity) is best designed through community collaboration and consultation with local and international advocates. This collaborative process ensured that the draft local harm reduction policy acknowledged the input and needs of all stakeholders, and fostered increased government investment in meeting gaps in the Harm Reduction and HIV-related response in Makassar.