The Ministry of Health (Kemenkes) emphasized the urgency of providing equal and fair healthcare services as a crucial step in protecting vulnerable groups, especially those living with tuberculosis (TB) and HIV. Imran Pambudi, Director of Healthcare Services for Vulnerable Groups, revealed that structural barriers and social stigma remain major obstacles complicating their access to decent medical treatment.
Along with the increasing life expectancy through antiretroviral therapy, the population of people living with HIV (PLHIV) in Indonesia is now entering the elderly phase. Data shows that around 7.7 percent or approximately 39,000 PLHIV in Indonesia are over 50 years old. This condition demands the preparedness of the healthcare system to manage the complexity of comorbid diseases, such as cognitive impairment, cardiovascular problems, and osteoporosis, which are often experienced by elderly patients.
Imran highlighted the challenge of service fragmentation, where the elderly have to visit many different clinics to receive various treatments. This condition is considered not only to burden patients in terms of cost and time, but also to increase the risk of treatment failure due to lost to follow-up. In addition, TB diagnosis in the elderly is often hindered because the symptoms frequently resemble the natural aging process, thereby risking delayed detection and expanding potential transmission within the household environment.
As a strategic step, the Ministry of Health plans to strengthen early detection through integrated health posts for the elderly (posyandu lansia) and nursing homes, as well as to increase the capacity of healthcare workers in safely managing polypharmacy or the use of multiple medications. The main focus going forward is to create an inclusive referral system, including for people with disabilities, and to optimize the role of the community in assisting patients to ensure the continuity and effectiveness of long-term treatment.
