11 JULY 2014 • VOL 345 ISSUE 6193 163 SCIENCE sciencemag.org
what do we do? It is estimated that we have
330,000 kids injecting. Do we want to kill
them or save them? If we don’t do anything,
if we keep fighting, they will die. They
will die of AIDS. They will die of overdose.
They will die of hepatitis. They will die in
prison because they’ll beat them in there.
If we want to save them, we have to work
together.” There was silence. Total silence.
But then I was very happy because it was
the police who said, “Ibu, you’re right. We
have to save our kids. Actually, my son is a
drug user and I don’t know what to do.”
Q: What happened?
A: First of all, I said, “The law says they’re
criminals and we should decriminalize
them.” We put a new regulation together,
but it was very hard to convince the different ministers. So I invited our colleagues
from Australia to do a cost analysis and
presented that in front of all the ministers
and said, “This is what it will cost us if they
all get HIV infected and hepatitis.” That was
the thing that changed it.
Q: Did you have needle and syringe exchange
right away or was that a battle also?
A: I knew that the NGOs had started it,
Q: The government accepted it?
but they were hiding under cover. It was
illegal and if they were caught, they went to
prison. But I’m very proud to say we have
very courageous NGOs. These NGOs got
together with the networks of people who
inject drugs. And then the Global Fund pro-
vided the resources.
A: Not always very happy, but we did it.
Q: When you became minister, you had to
very quickly fight over condoms.
A: We’ve been fighting about condoms
since the minute I came back from Geneva
when I was secretary of the National AIDS
Commission. As the minister it was different, you see. Here was an amoral minister
of health who is promiscuous who wanted
to distribute condoms to schoolchildren.
So they demonstrated. I said, “OK, come
in.” So we talked and I gave them the data
of sexual transmission, of housewives being infected and babies born. I said, “Look,
what else can we do? You’re religious leaders, and you have been telling them that
they are not allowed to go to brothels or
whatever, but I cannot do that. I’m just the
minister of health. All I can do is prevent
the transmission of the disease and I can
only do that with condoms.” Then they
said, “Yeah but it’s wrong if the government does it.” And they said, “You have to
beat them in public. Beat them to death.
It’s the Islamic Shariah.” And I said, “But
it’s not in our law.” So I said, “Let’s agree
to disagree. You do your work so that no
man will ever go to brothels and no young
person will ever have sex before marriage.
I will do my work with those who engage
in risky sex and tell them to wear
Q: You came from a Muslim background
and converted to Catholicism. How do you
view the Islamic community that challenges
prevention interventions because they violate
their moral tenets?
A: It has changed a lot actually. From the
beginning, there was only a small group
who were really aggressively looking at
[HIV/AIDS] from the moral point of view.
A lot of people actually knew that yes,
what we were doing was the right thing to
do. All they needed was somebody to be
the—how do you call that?—the one to get
the stones thrown at.
Q: They’re still throwing stones at you. Mus-
lim leaders attacked National Condom Week
in December 2013, and the Health Ministry
halted the annual event.
A: Yes, yes. But not as fiercely as before.
Q: One criticism is that the government
hasn’t spent enough on the MSM community.
What do you think?
A: Yeah. It is because we believe that MSM
can only be reached by their peers. It’s not
that I don’t want to spend money. Unfortunately, there are still a lot of districts or
provinces where this cannot be done by
our local government. Once I had to basically fire the secretary of the local AIDS
commission because he said, “Ibu, I will
do anything you say, but don’t ask me to
work with men who have sex with men.
It’s against my conscience.” And I said,
“Then you cannot be the secretary of the
local AIDS commission.” MSM is still much
hated in many areas in Indonesia, I’m
sorry to say.
Q: Your supporters are worried about you
getting kicked out of office with the elections
A: Most probably so, yes.
Q: Are you worried about whether there will
A: I am, but the only thing I can do is
strengthen my colleagues who will still
be here, empowering them, as well as the
NGO community. We have a strong NGO
community, and they need a stronger
voice in the government. And I can still
do things from outside, I think. I may not
be as powerful as the minister, but I can
always say what I want. ■
Nafsiah Mboi pushed through
harm reduction efforts.