Strict Indonesia Backs Free Needles for Drug Users

Using donor funds with a quiet nod from local authorities, Yayasan Hati-Hati (Take Care Foundation) in Denpasar, Bali's capital, hands out hundreds of needles a month to drug users. For Indonesia, whose strict drug laws include penalties for carrying a needle without a prescription, helping addicts inject drugs safely would have been unthinkable in the past. But the alarming rise in infections from needle-borne HIV and hepatitis has changed that attitude, at least in some government circles.

Other Asian countries are experiencing a similar shift, following the lead of European nations that have long recognized the limits of law enforcement efforts against drug addition. China recently approved needle exchanges in six provinces, and India has similar projects running in Manipur state, a prime heroin-smuggling route.

Harm reduction advocates say Asian leaders must be pragmatic if they want to stem the transmission of HIV among drug users through needle sharing, and into the general population through unsafe sex. The Bali project is one of two needle exchanges in Indonesia that have received government backing, if not explicit legal approval, in the past six months. Using US and Australian funds earmarked for AIDS prevention, six more exchanges are to open around the country by year's end. Exchange workers in Bali say so far the police have taken a hands-off approach, recently issuing identity cards to workers who distribute needles.

Yet the notion that addicts should be helped, not hindered, remains controversial in Indonesia, as it does in many countries. Across Asia, police and anti-narcotics officials worry that harm reduction sends the wrong message to young people and undermines years of stern anti-drug campaigns. The result is often a clash between public health officials, who tend to support harm reduction even if it breaks the law, and security officials, who dislike bending the rules. Harm reduction advocates insist they are not promoting drug use, but rather accepting that, until addicts can break their habit, safer behavior is paramount.

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