A workshop on Methadone Maintenance Therapy (MMT) was held inJakarta, Indonesia on 17 September 2008 with the support of the Gerbang Foundation and Family Health Indonesia (FHI). Representatives from 12 Jakarta methadone clinics, NGOs, donoragencies, the Department of Health and people taking methadoneattended the workshop to discuss ways of improving the effectivenessof methadone programs.
Dr Dien Ernawaty, head of a sub-directorate of the Department ofHealth, said during the workshop's first presentation that 2240 casesof HIV had been found among injection drug users (IDUs) in the city. According to Ernawaty, drug abuse prevention programs, supply anddemand reduction efforts, harm reduction and HIV and AIDS preventionprojects were government priorities under the Public Policy of Harmreduction.
The increasing size of the IDU community along with increasedpressure on methadone treatment centres and high levels of stigma anddiscrimination were just some of the issues that needed to be tackled,Ernawaty said.The lack of a national standard operating procedure for MMT,training for public healthcare workers and differences in reportingstandards and formats also needed to be urgently addressed accordingto Dr Dyah Mustikawaty of the Drugs Dependency Hospital in Jakarta. He said low levels of funding and monitoring as well as limitedservice times, space and equipment made the provision of MMT difficultfor the public health system. Following his presentation, workshop members discussed whether ornot there was any regulation of the cost of methadone treatment inJakarta and a number of other issues related to the provision ofmethadone services.
After the discussion session four more presentations were given byrepresentatives from public MMT clinics, the Cipinang Narcotics prisonin East Jakarta, the Central Jakarta Methadone Support Group and theNorth Jakarta district police office.According to the presentation of the representative from thenarcotics prison, between 40% and 50% of 2800 inmates used heroin and540 of 1128 tested positive for HIV. Illegal drugs were stillavailable to inmates in prison and many dropped out of MMT programsdue to a lack of information. Workshop Recommendations:
1. We demand community involvement in MMT programs to increase thequality of services.
2. We demand the improvement of infrastructure in methadone clinics.
3. HCPI will assess ongoing MMT services.
4. We demand the restructure of MMT management systems.
5. We demand the development of comprehensive M&E Tools for MMTprograms.
6. We demand an increase in the number of places at MMT clinics inJakarta.
7. We demand increased antiretroviral services at MMT clinics.
8. We demand routine coordination among MMT clinics in publichealth centres, the provincial AIDS council, the Department of Healthand communities of people using methadone.
9. We demand the development of SOP for MMT inside prisons.
10. We demand the improvement of psychosocial services for peopleon MMT.
11. We demand intensive advocacy and socialization withininstitutions such as the police and the National Narcotics Board.
12. We demand the involvement of parties other than the Ministryof Health in MMT programming.
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