Despite legal reforms, civil society monitoring shows that intolerant and discriminatory by-laws still exist in the country, especially against groups that are highly stigmatised. For example, in December 2021 the local government of District of Bogor City Government (West Java) established a Regional Regulation for the Prevention and Regulation of Sexual Deviant Behaviour (P4S). This regulation’s brittle complexity and stigmatisation of sexual and gender minority groups (LGBT) are the reasons it has become a contentious issue and drawn condemnation from a range of activist and human rights watchdog groups. Despite so, the regulation eventually was approved by the Bogor City Council and was officially implemented throughout the city.

The regulation characterises LGBT individuals as forms of “sexually deviant”, regarded in the same category as pedophiles, that negatively impact social life and further alter mental attitudes that could undermine the foundations of social life. The regulation further regulates the need for public security management, forced rehabilitation and conversion therapy for people who are deemed to have “sexually deviant” behaviour – a clear violation of the right to health. Finally, being identified as LGBT could also potentially lead to sanctions, including imprisonment (criminal), fines, and/or other sanctions pursuant to other the regulations in force in Indonesia.

In its reply to the list of issues, the government of Indonesia provides sparse information on steps implemented to align domestic drug policy with international standards.

On December 6, 2022, Indonesia’s House of Representatives passed a long-debated New Criminal Code (Law Number 1 Year 2023 Regarding the Criminal Code), which includes articles regarding drug-related crimes, notwithstanding the existence of specific rules in the Law Number 35 Year 2009 regarding Narcotics (Narcotic Bill). Rather than aligning domestic policy with international standards, this new criminal code represents another challenge for drug policy reform in Indonesia, as it can potentially have wide-ranging negative impacts on people who use drugs. Despite civil society’s criticism since the beginning of the reform discussion to remove the drug regulations from the criminal code, the government continued with this codification process by justifying the placement of narcotic articles in the Penal Code as “bridging articles”, a concept which remains unclear.

The drug regulations outlined in the New Criminal Code, in fact, fail to address significant issues related to drug policy, including the issue of harm reduction. Not only the Criminal Code does not mention harm reduction at all – but it continues criminalising people who use drugs, as it fails to discriminate between drug use and drug trafficking; hence representing an often insurmountable obstacle to the provision of essential services, and to the enjoyment of economic, social and cultural rights by people who use drugs.

Indonesia’s punitive approach to drugs transpires from most related policies and laws. One example is the National Narcotic Board’s regulation on the implementation of rehabilitation services of 2014.14 The regulation creates a mechanism known as ‘Integrated Assessment Team’ (Tim Asesmen Terpadu/TAT), whose role is to determine whether individuals arrested for violating drug laws qualify as a ‘people who use drugs’, in which case rehabilitation would be recommended instead of incarceration. However, the assessment can only be undertaken if the police officers responsible for the case refer the arrested individuals to the TAT. In practice, according to people arrested, this has become a chance for the police to ask for bribes. And in many cases, the referral simply does not happen; resulting in higher sentences and a lack of access to healthcare for arrested persons who use drugs.

Although most of these regulations acknowledge the concept of drug use and drug dependency – the terms used in the laws are ‘drug abuse’ and ‘drug addict’, its flawed implementation means that people who use drugs still have to undergo criminal proceedings and in many cases be sentenced to imprisonment, or undergo forced rehabilitation as a mean to avoid imprisonment regardless of their level of dependency.

The latest available estimates indicate there are at least 34,500 people who inject drugs in Indonesia, with a national HIV prevalence estimated at 39.11% (HIV prevalence among prisoners is estimated at 0.7%) and an estimated Hepatitis C prevalence among people who inject drugs at 89.2%.

Some harm reduction services are available, although limited, in the country;  mostly government-run. For example, OAT is available in several regions, and the number of Needle and Syringe Programs (NSPs) increased from 53 to 56 between 2018 and 2020. However, the acceptability and quality of such services are reportedly poor. For example, 216 syringes per person per year are reportedly distributed against the WHO target of 300, and OAT coverage is reportedly particularly low, with only 1.6% of people who could benefit from these programmes receiving methadone. Other essential services, such as peer distribution of naloxone or drug consumption facilities, are absent.

HIV testing among people who inject drugs is also very limited at 26.9%; while there are no known HBV and HCV testing and treatment programmes targeted to people who use and inject drugs, although it is reported that they can access the treatment. This is despite the updated WHO Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment, and care for key populations that include people who inject drugs, people in prisons and other closed settings as part of a public health response, and the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund)’s harm reduction technical brief in 2022 that considered harm reduction as a ‘program essential’; further allowing funding requests for programmes for people who use drugs and their sexual partners, rather than only people who inject drugs, increased the scope for stimulant harm reduction and hepatitis B and C treatment for people who inject drugs regardless of HIV status.

The situation is even more dire in prisons. Although prisoners have the right to the same standard of care as people in the broader community – including harm reduction services – no NSPs, condoms distribution, nor distribution of naloxone are available in Indonesian prisons. The only intervention to be present in detention is OAT, which in 2018 was only reported in 11 prisons in the country, most of them located in big cities. In other cases, people in prison who were enrolled in an OAT programme outside of prison access methadone only through their family members or lawyers.

Funding for harm reduction and hepatitis C is heavily tied to grants from international donors. There has been no domestic public financing directed towards community or civil society organisations to date. While social contracting is permitted within government regulations, this has not been used as a mechanism for funding the HIV or harm reduction response in Indonesia. Unfortunately, the Indonesian government has not shown commitment to transitioning from international donor-funded to domestically funded harm reduction programmes.

Furthermore, the ongoing effort to revise Indonesia’s narcotic law poses a threat to the continuation of the harm reduction programme in the country due to a push to remove the article regulating medical rehabilitation for people with drug dependency.

1. Undertake a comprehensive assessment of all laws and policies that are discriminatory in nature or in practice, and that promote intolerance, with an aim to repeal such laws and regulations;
2. Take urgent steps to introduce a specific anti-discrimination law;
3. Ban all kind of forced rehabilitation and “conversion therapies” for LGBT individuals that further violate economic, social and cultural rights, including but not limited to the right to health, the right to education, and the right to work;
4. Taking advantage of the national process of revising the Narcotic Laws, to fully align domestic legislation with international standards, inluding by adopting “alternatives to criminalization, “zero tolerance” and elimination of drugs, by considering decriminalization of usage; and adopt responsible regulation that promotes human rights;”
5. “Adopt drug policies that recognize and advance the rights of people who use drugs, including by ensuring access to medical care for people who inject drugs and develop HIV, viral hepatitis and other blood-borne infectious diseases;” and by ensuring drug treatment is only pursued with the consent of the person, and never as an alternative to incarceration;
6. “Ensure that drug-dependent treatment is voluntary, and informed consent is a precondition for any medical treatment or intervention;”
7. Scale up provision of harm reduction services, including in prison settings as a matter of priority to ensure availability, accessibility and quality access to services;
8. Implement and fund a programme for the roll-out of the International Guidelines on Human Rights and Drug Policy at the domestic level, including training for policymakers, healthcare professionals, and service providers.