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| Dr Imran Pambudi Ministry of Health, Indonesia |
"Ending AIDS and ending TB is not only about controlling infection - it is about putting people first," Dr Pambudi said.
Putting people first is non-negotiable if we are to move from disease control mode to disease elimination mode.
He said community-led HIV and TB interventions should be judged not simply by their reach or the number of people served, but by their impact on people's lives and their ability to remove barriers to care.
Dr Pambudi has over two decades of experience of leading national programmes in HIV/AIDS and TB control, pandemic preparedness, and youth mental health, while championing inclusive healthcare for marginalised communities.
Young people still face gaps in HIV services
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| Bella Aubree Inti Muda Indonesia |
Aubree said Indonesia’s HIV response broadly targets key populations but lacks sufficient infrastructure specifically designed for young key populations under 18 who acquire HIV through horizontal, rather than vertical, transmission.
The result, she said, is a “missing wedge” in HIV programming.
Among the barriers are clinic hours that conflict with school schedules, fear of disclosure to parents or guardians, a shortage of adolescent-sensitive HIV services and limited youth-specific peer support.
“These” young people, she said, can remain untested and therefore untreated and/or virally unsuppressed, or be lost before they are linked to care.
Aubree described a community-based approach that combines demand generation, peer outreach, digital engagement and youth events with practical access to testing and treatment.
Social media and digital platforms can build awareness, trust and motivation to test, while youth festivals, community events and HIV literacy programmes can improve young people’s understanding of HIV and their perception of risk.
Bringing HIV services closer to youth
But creating demand is only the beginning, Aubree said. Services also must be safe, accessible, acceptable and youth-friendly.
In Indonesia, this has included point-of-care and decentralised testing, hotspot outreach and door-to-door services. Such services remain particularly important in a country where geographical distances can make reaching health facilities difficult.
“Door-to-door services are still needed by the youth in Indonesia,” Aubree said, adding that extended clinic hours also are needed for adolescents and young adults whose school schedules make conventional clinic hours difficult.
The community response, she said, also needs mental health and psychosocial assistance, paralegal support, community-led monitoring and policy advocacy.
Community-led monitoring allows young people to provide feedback about the quality of services and use the findings to advocate for changes with health authorities and the Ministry of Health of Indonesian government or sub-national governments in the country.
Aubree emphasised that community advocacy remains essential even as new technologies, including artificial intelligence, become increasingly prominent in health programming.
She said communities must continue to help bridge the gap between health providers and people who may distrust formal systems.
“Marginalised young key populations trust communities first,” she said.
In Indonesia, this has included point-of-care and decentralised testing, hotspot outreach and door-to-door services. Such services remain particularly important in a country where geographical distances can make reaching health facilities difficult.
“Door-to-door services are still needed by the youth in Indonesia,” Aubree said, adding that extended clinic hours also are needed for adolescents and young adults whose school schedules make conventional clinic hours difficult.
The community response, she said, also needs mental health and psychosocial assistance, paralegal support, community-led monitoring and policy advocacy.
Community-led monitoring allows young people to provide feedback about the quality of services and use the findings to advocate for changes with health authorities and the Ministry of Health of Indonesian government or sub-national governments in the country.
Aubree emphasised that community advocacy remains essential even as new technologies, including artificial intelligence, become increasingly prominent in health programming.
She said communities must continue to help bridge the gap between health providers and people who may distrust formal systems.
“Marginalised young key populations trust communities first,” she said.
Policy barriers leave vulnerable youth invisible
Aubree pointed to a major policy barrier that young people in Indonesia faced before 2022: access to HIV testing for those under 18 previously required parental consent.
For young people who feared anger, discrimination or disclosure within their families, bringing a parent to obtain an HIV test could be a significant obstacle.
Community advocacy helped lead to a Indonesian Ministry of Health regulation allowing not only parents but also community members and outreach workers to accompany young people under 18 for HIV testing.
But Aubree said a policy on paper does not automatically guarantee implementation.
She and other advocates have continued pressing for a circular letter to be sent to health services throughout Indonesia so facilities clearly understand that young key populations under 18 can access HIV testing under the new framework.
She said the advocacy has already taken years.
“If there is a policy barrier,” she said, “this is something that we need to change.”
The issue reflects a broader challenge for Indonesia’s HIV response: ensuring that national policies translate into services that people can actually use. Recent reviews of Indonesia’s HIV programme have also identified continuing gaps in coordination, service integration and sustainability, alongside the need for stronger community support and stigma reduction.
Safety, population ageing and disability rights must make services more inclusive
For Dr Pambudi, addressing such barriers is part of a broader commitment to ensuring that vulnerable people are not excluded from the HIV and TB responses.
He identified three priorities: safety, an end to ageism and accessibility for people with disabilities.
“Safety is health,” Dr Pambudi said, arguing that violence prevention must be integrated into HIV and TB programmes because people living in fear may be unable to access services or adhere to treatment.
He also called for greater attention to people living and aging with HIV.
Many people living with HIV are now long-term survivors, he noted, yet services too often remain designed primarily around younger populations. Older adults living with HIV should be included in clinical protocols, social protection and community support, he said.
Accessibility, meanwhile, must be treated as a matter of dignity. Clinics, information systems and outreach programmes that exclude people with physical or cognitive disabilities undermine the commitment to put people first.
Dr Pambudi also called for HIV and TB programmes to break out of “critical silos” and connect with mental health, reproductive health and social protection, while becoming more deeply embedded in schools, workplaces and digital platforms.
TB survivors transform from survivors to champions and leaders
Indonesia’s TB response faces a similarly important challenge: ensuring that people affected by the disease have a meaningful role in shaping the response.
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| Muhammad Tanwirul Huda Rekat Peduli Foundation/ TB People Indonesia |
More than 1 million people develop TB each year in Indonesia, he said.
Although effective treatment is available, many people affected by TB confront challenges that medicine alone cannot resolve: stigma, discrimination and social isolation.
For people with drug-resistant TB in particular, the burden can include losing employment, losing hope and feeling that 'others do not understand' what they are experiencing.
“Ending TB is not only about medical science - it is about people,” Huda said.
Rekat Peduli Indonesia hosts TB People Indonesia, a national network of TB survivors with chapters in nine provinces. The network seeks to ensure that people affected by TB are not merely recipients of services but active participants in shaping policies, processes and programmes that affect their lives, said Huda. TB People Indonesia's work includes peer support, community-led monitoring and training community paralegals to address stigma, discrimination and barriers to TB services.
Community paralegals have provided direct assistance to more than 200 people affected by TB, including legal and psychological support, treatment navigation and referrals.
Huda added that TB survivors also serve as educators, advocates, supporters and community mobilisers. They help identify people with TB, encourage treatment adherence, support contact investigation and work alongside health workers and government institutions.
Community financing becomes increasingly important
As international donor funding declines, sustaining these community responses is becoming more difficult. Huda called for stronger domestic financing, arguing that community engagement should not depend primarily on external donors.
“Communities are not optional partners - they are an essential part of a resilient health system,” he said.
Accountability is essential to reaching 2030
For Indonesian Ministry of Health leader Dr Pambudi, accountability should be central as the 2030 deadline approaches. Success, he said, cannot be measured only in infections averted. It also must be measured in dignity.
“We cannot achieve the goals otherwise,” he said, urging governments and partners to listen to communities, resource them adequately and close the gap between "what is proven to work" and "what is actually implemented."
Aubree likewise argued that communities must have a defining role in changing systems, particularly where policies continue to leave young people behind.
Dr Pambudi Aubree and Huda, all were speaking in an event around the largest global AIDS conference of 2026, the 26th International AIDS Conference (AIDS 2026) in Rio de Janeiro, Brazil.
They all communicated in their own messaging and contexts that the fight against HIV and TB cannot be won by health systems working for communities without communities having a meaningful role in leading the response.
“Let us move beyond seeing people affected by TB merely as patients,” Huda said. “Let us recognise them as partners, leaders, and decision-makers.”
Dr Pambudi summed up the broader challenge by calling for HIV and TB interventions that allow every person - young or old, with or without disability - to live free from disease and stigma.
If communities are placed at the centre, he said, the goal is not simply to end AIDS and TB as public health threats, but to build healthier communities where people can live longer, experience better mental well-being, age with dignity and rights, and reach their full potential.
(Citizen News Service)
17 August 2026
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