Put People First: Indonesia Pushes Community-Led HIV, TB Response
By Shobha Shukla – CNS
With just over four years to the 2030 Sustainable Development Goals deadline, Indonesian health officials and community advocates say the fight against HIV and tuberculosis must shift from treating diseases to removing the barriers that keep people from care.
Speaking around the 26th International AIDS Conference (AIDS 2026) in Rio de Janeiro, Indonesian Ministry of Health official Dr Imran Pambudi said stigma, discrimination, violence, ageism and poor accessibility could undermine progress even where effective medicines are available.
“Ending AIDS and ending TB is not only about controlling infection, it is about putting people first,” Pambudi said.
He called for HIV and TB programmes to be judged not only by the number of people reached, but by whether they make services safer, more accessible and easier to use.
Young people falling through the gap
For Bella Aubree, a transgender woman and National Coordinator of Inti Muda Indonesia, young people from key populations remain one of the gaps in Indonesia’s HIV response.
She said adolescents under 18 can face clinic hours that clash with school, fear of disclosure to parents, limited youth-friendly services and inadequate peer support.
“Marginalised young key populations trust communities first,” Aubree said.
She advocated a combination of peer outreach, digital engagement, community events, decentralised testing and door-to-door services, alongside mental health and psychosocial support.
Community-led monitoring, she added, gives young people a way to report problems with health services and push authorities to act.
Aubree also pointed to policy change as evidence that community advocacy can shift systems. Indonesia previously required parental consent for HIV testing by people under 18.
A Ministry of Health regulation later allowed community members and outreach workers to accompany young people for testing.
But she warned that policy changes must reach health facilities and be implemented consistently.
TB survivors want a seat at the table
The same principle is being pushed in Indonesia’s TB response.
Muhammad Tanwirul Huda, Strategic Partnership Officer with Rekat Peduli Foundation Indonesia and host of TB People Indonesia, said the country’s high TB burden is compounded by stigma, discrimination, social isolation and economic hardship.
“Ending TB is not only about medical science, it is about people,” Huda said.
TB People Indonesia, a network of survivors with chapters in nine provinces, provides peer support, community-led monitoring and paralegal assistance.
Its community paralegals have supported more than 200 people affected by TB with legal and psychological assistance, treatment navigation and referrals.
Huda said survivors should be seen as partners and decision-makers rather than passive recipients of treatment.
“Let us move beyond seeing people affected by TB merely as patients. Let us recognise them as partners, leaders, and decision-makers.”
Inclusion cannot wait
Pambudi said putting people first also means confronting three often-overlooked issues: safety, ageism and disability.
“Safety is health,” he said, arguing that violence prevention must be integrated into HIV and TB programmes.
He also urged health systems to adapt to the growing number of people ageing with HIV by including older adults in clinical protocols, social protection and community support.
People with physical or cognitive disabilities, he added, must be able to access clinics, information and outreach services without facing avoidable barriers.
Both HIV and TB programmes also need stronger links with mental health, reproductive health and social protection, he said.
Communities need sustainable funding
As international donor support declines, Huda warned that community-led programmes face growing financial pressure.
He called for greater domestic investment, stressing that community organisations are not temporary partners to be funded only when external grants are available. “Communities are not optional partners — they are an essential part of a resilient health system,” he said.
For Pambudi, the test of the 2030 agenda is therefore bigger than the number of infections prevented.
Success must also mean that people can access care without fear, stigma or discrimination, regardless of their age, disability or identity.
The message from Indonesia is straightforward: health systems cannot end HIV and TB by working for communities without giving communities a meaningful role in shaping and leading the response.
Shobha Shukla – CNS (Citizen News Service)
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