对于Agus（化名）来说，生命的结束并不代表人生的终结。作为一名注射吸毒者，他死后面临一个新问题。两天前，这位血液中查有HIV病毒的吸毒者死于艾滋病引发的某些疾病和感染。在巴厘岛，一个人的死亡通常不仅是其家庭的责任，也是这个传统的本地社区，被称为班查尔的地方的责任。
通常，这种责任包括洗浴、埋葬、火化和一场传统告别会。但是Agus却得不到这些。这不仅因为他所从属的社区不接受他，他的家庭也不愿意承担这一切。
幸运的是，Agus还有许多朋友，曾经和他一起吸毒的人，以及艾滋感染者。他们把Agus的遗体带回之前为他治疗的地方，巴厘省最大的医院 -- Sanglah医院。 大约一星期以前，同样的故事也发生在Budi（非真名）身上。他也是巴厘岛的一名艾滋感染者。当地居民因为他的这种情况也拒绝接受他。
发生在Agus和Budi身上的事情在巴厘岛和印尼的艾滋感染人群中很正常，他们面临同一威胁：歧视。这些故事也显示了，写在文件里的政策和现实中发生的事情大不相同。
目前，在印尼的33个省中，巴厘是印尼HIV/AIDS病例最多的5个省之一。根据卫生部的数据，截至12月底印尼共有16110例艾滋感染者，巴厘有1177例。
卫生部显示的数据与巴厘省卫生办公室的数据截然不同。根据后者，2008年10月止，巴厘省有2323例艾滋感染者。
2006年的《成年危险人群估计》显示了一个更加极端的例子。这份报告称有一部分人特别容易受到感染，即性工作者和艾滋感染者人群的配偶们，他们的数目大约在400万到800万之间。但是最大的高危群体还是注射吸毒者。根据2006年的一份数据显示，印尼艾滋病感染者的数量在169,000到217,000之间，其中46%是注射吸毒者，14%为性工作者。
这些数目的增大也显示在艾滋病的传染模式里。疾病从最初的圈子，如注射吸毒者和性工作者，开始扩散到普通人群。这个模式在巴厘和巴布亚明显可见。
印尼的艾滋病政策旨在通过多个方法对付此传染病。但是，在现实操作中，这个国家还面临着污名、歧视和资金缺乏这些经典问题。
根据《国家行动计划2007-2010》，印尼的艾滋病项目将把注意力集中于以下三点。第一，项目主要针对注射吸毒者和性工作者群体。第二，预防通过注射器传染和预防新HIV感染的性传播是首要处理的问题。第三，项目主要集中在19个省，虽然有份估计声称整个印尼的80%都受到了感染。
为了支持印尼已经为之制定了政策的三项大型计划，政府已经采取了以下措施：1）《总统法令1994年36号 》设立了国家艾滋委员会（NAC）和地方艾滋委员会，协调艾滋政策的实施；2）公开承诺接受《联合国关于HIV/AIDS问题的联合国大会特别会议2001决议》，作为对付艾滋问题的扩展框架。3）2004年，6个拥有最高艾滋病感染率的省签署了《逊达尼承诺》，象征着对艾滋病的打击运动。4）国家毒品委员会与国家艾滋委员会签署了关于减害计划的《理解备忘录》。
2006年3月，巴厘岛政府发布了号为3/2006的《区域规章》，提到了HIV/AIDS。这一规章计划与其他公共和非公共项目一起合作，包括艾滋病预防运动、主动咨询性检测和其他的照护机制、支持和治疗项目。《区域规章》第20条第1段规定所有人根据法律都对HIV/AIDS负有一定义务，其中一条就是禁止歧视艾滋感染者。
但是，在现实生活中，对他们的歧视仍然存在。例如，巴厘的艾滋感染者Adi提到他的朋友们就是因为是艾滋感染者而被医生拒绝检查。
其他许多这些规定都很快失败，正如印尼的艾滋病例数目所示。特别是在前5年间，艾滋病例数量快速攀升。卫生部公布的2006新艾滋病例数目为2873。这个数目是此传染病前17年的年发病率（大约1371例）的2倍。
最近，巴布亚省立法分支机构公布了一项有争议的计划，即在艾滋感染者身上放置芯片。许多部门和组织，特别是非政府组织对此计划表示反对，因为他们认为这是非人性的，是歧视。但是，这份计划也直接显示出大量的立法人员对HIV和艾滋病及其治疗缺乏了解。
理论与现实的脱节不仅在于歧视现象的继续存在，也表现在HIV/AIDS预防与减害资源。虽然有好几项计划制定成了法律法规制，但是巴厘当地政府并没有彻底实施。例如，监狱里的针头交换计划就还没有被实施，虽然《规章》保证会实施此计划。
在实施规定的时候，写在纸面上的这些规定与制定的和未制定的政治决策并不相符。这一点最明显的表现就是政府无法给这些项目和政策提供足够的资助。据估计4年（2007-2010）大约需要资金75.8万亿印尼盾（约合美元6亿3千1百万），用于预防、照护、支持和治疗、管理和减害。但是，估计每年可获得的资金只有5970亿印尼盾（约合美元4900万）。政府只能提供大约20%的总资金，而80%来自于捐赠者。 因此，印尼非常依赖捐赠者。用另外的话说，讽刺的是，印尼对抗艾滋病在很大程度上还要依靠捐款。
Indonesian AIDS Policy: "On the ground" Isn't as Good as "On Paper"
For Agus, fictitious name, the end of life was not the end of a journey. As a former injection drug user (IDU), he faced a new problem when he passed away. Two days ago, the IDU died from complications arising from AIDS. Often in Bali, a person who dies is the responsibility of not only their families, but also of the traditional local community, called banjar.
Normally, this care consists of bathing, burying, cremation, and a traditional farewell ceremony. But not for Agus. Agus's body was rejected not only by his family, but by his community, as well.
Fortunately, Agus still had many friends: fellow users and former IDU and people living with HIV and AIDS (PLWHA). So, these friends brought Agus's body back to Sanglah Hospital, the biggest hospital in the Province of Bali, Indonesia, where it was treated. About a week before, the same story happened with Budi (not real name), another of the PLWHA in Bali. Because of his HIV/AIDS status, Budi's body was also rejected by the residents.
The
examples of Agus and Budi are common among PLWHA in Bali and
Nowdays, out of the 33 provinces in Indonesia, Bali is one of the five provinces with the highestnumber of cases of HIV and AIDS in Indonesia. Based on data from the Ministry of Health (MOH), the number of cases in Indonesia until December was 16,110. Bali's case total alone was 1,177.
The data presented by the MOH is far different from the data presented by the Bali Provincial Health Office. According to the Bali Provincial Health Office, by October 2008 data cases in the province reached 2,323 cases.
A more extreme example is shown in the Adult At-Risk Population Estimate in 2006. That report estimated that some of the people most at risk of infection, sex workers and spouses of PLWHA, numbered from 4 million to 8 million. However, the largest at-risk group remains IDU. According to the results of a 2006 estimate, the number of PLWHA in Indonesia is between 169,000 and 217,000, where 46 percent of them are IDU, while 14 percent are sex workers.
The increase in these numbers reflects the details of the pattern of transmission. From the original circles, such as IDU and sex workers, the disease began to spread to the general population. This pattern can readily be seen in Bali and Papua.
The
overarching AIDS policy in
According to the National Action Plan 2007-2010, the AIDS program in Indonesia was to be conducted with attention to the following three things: First, the program is directed primarily to reach a sub-population of IDU and sex workers. Second, the prevention of transmission through syringes and the prevention of the sexual transmission rate of new HIV infections were to be priorities. Third, the scope of the program is only focused on 19 provinces, although one estimate states that 80% of the whole of Indonesia is affected.
To support the three large programs in which Indonesia already has policies, the government has taken the following steps: 1) Presidential Decree Number 36 Year 1994, establishing the National AIDS Comission (NAC) and Regional AIDS Comission to coordinate the implementation of AIDS policy; 2) a public commitment to adopt the 2001 resolution of the United Nations resolution General Assembly of the Special Session on HIV and AIDS (UNGASS), as a framework in the expanded response to AIDS; 3) the signing of the Sentani Commitment in 2004, by the six provinces with the highest levels of HIV prevalence as a symbol of the movement in the fight against AIDS, and 4) the signing of a Memorandum of Understanding (MoU) between the National Drugs Board and the National AIDS Comission about harm reduction.
In March 2006, the Government of Bali (Perda) published Regional Regulation 3/2006 with regard to HIV and AIDS. This regulation was intended to operate alongside other public and non-public programs, including campaigns for prevention, voluntary counseling testing (VCT), and other mechanisms of care, support, and treatment. Article 20 paragraph (1) in the Regional Regulation states that all people have certain obligations with respect to the HIV/AIDS, one of them being the prohibition of discrimination against PLWHA.
However, in practice, there is still discrimination against PLWHA. For example Adi, one of the PLWHA in
Many
of these other laws and rules have also been rapidly defeated, as reflected in the number of AIDS cases in
Recently there was a controversial plan by the Papua Legislative Branch to put microchips on the bodies of PLWHA. Many sectors and organizations, particularly the Non-Government Organization (NGO) community, opposed the plan because they considered it to be inhumane and discriminatory. However, that plan directly indicates that a high number of legislative members still have a poor understanding about HIV and AIDS and how to treat the PLWHA.
The disconnect between theory and practice exists with respect to discrimination, but also with respect to HIV/AIDS prevention and harm reduction resources. There are several programs that have not been fully implemented by the local government of Bali, although they have been created by laws and statutes. For example, needle exchange programs (NEP) in prisons still have not been implemented, even though the Regulation permis the creations of these programs.
Again, the rules on paper are not synergistic with the political decisions made, and not made, while implementing these rules. This is nowhere more evident than in the inadequate government funding for these very programs and policies. The estimated amount of funds needed for four years (2007-2010) is about Rp 7.58 trillion (about US$ 631million) for prevention, care, support and treatment, management, and mitigation. However, the estimated availability of funds per year is only Rp 597 billion (about US$ 49 million). Government contribution was only about 20 percent of the total funds, while 80 percent came from donors. Thus, Indonesia remains very dependent on donors. In other words, ironically, Indonesia is still reliant on the benevolence of colonialistic funding from which it has attempted to move away for so long.
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