Prodita Sabarini, Jakarta – An obsolete approach that sees drug users treated like criminals instead of victims is the main cause of overcrowding and HIV/AIDS related deaths in prisons, the National AIDS Commission says.

Inang Winarso, assistant to the commission's deputy secretary, said Thursday that the current prison health crisis was the result of a "paradigm that views drug users as criminals."

He added that National Police chief Sutanto's 2002 instructions to police to get tough on drug-related cases had resulted in thousands of already ill drug users being imprisoned.

He said that nationwide, prison sentences for drug-related cases had increased fivefold, to 34,166 to 7,211, in the last five years.

"Only two percent of the convicts are drug dealers, while the others are drug users. These are the ones who are sick and become even sicker inside prisons that are overcrowded, poorly sanitized and lacking in adequate health care," he said during a discussion with officials from the Justice and Human Rights Ministry, prison authorities and non-governmental organizations.

Authorities have reported that the majority of deaths in the country's prisons are caused by HIV/AIDS, with Jakarta prisons having the biggest death toll. The city saw 351 of 19,000 prisoners die last year. Some 70 percent of the deaths were caused by HIV/AIDS.

HIV infection in Indonesia spreads fastest among drug injecting users who share needles. Drugs are easily available in prison but needles are scarce and inmates often share them.

While HIV/AIDS and other opportunistic infections such as hepatitis C and tuberculosis are a growing problem, the budget allocation for prison inmate health care is still extremely small.

Soejoto, Secretary General of Correctional Institutions at the Justice and Human Rights Ministry said that health care budget was only Rp 500 per inmate per day.

"Prisons are not a place for people to die. They are correctional institutes. However, with the overwhelming health problem, they're loosing their ability to function as places to restore people to go back into the community as good citizens," said Budi Sulaksana, an official from the drug case unit at the ministry.

Inang said that drug users should not be seen as criminals. "The country should change its paradigm of drug users. We should de-criminalize drug users, because they are sick people. The real criminals are the dealers," he said.

"Putting addicts in the same place as drug dealers, in prisons, where drugs are still available, is not a good idea."

Budi said that the 1997 Psychotropic Law allowed judges to send drug users to rehabilitation centers as well as jail. "But judges hardly look at this option."

Inang suggested the empowerment of community health centers to organize harm-reduction programs, such as providing methadone treatments to convicted drug addicts.

Commenting on the idea, Budi said there should be coordination with prison authorities, the Health Ministry and the police. "The justice ministry cannot make it alone," he said.