1 / 19

ARV Program in Indonesia: Advantages, Challenges and the Way Forward

ARV Program in Indonesia: Advantages, Challenges and the Way Forward. Dr. Endang Budi Hastuti National AIDS Program Ministry of Health of Republic of Indonesia. Outline Presentation. HIV/AIDS in Indonesia Overview of HIV/AIDS control system

thane
Download Presentation

ARV Program in Indonesia: Advantages, Challenges and the Way Forward

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. ARV Program in Indonesia:Advantages, Challenges and the Way Forward Dr. Endang Budi Hastuti National AIDS Program Ministry of Health of Republic of Indonesia

  2. Outline Presentation • HIV/AIDS in Indonesia • Overview of HIV/AIDS control system • ARV : financing, supply and distribution system • Advantages and challenges of current ARV supply chain management system • Future strategic plans in scaling up ARV program

  3. Estimation of PLWHA in Indonesia, 2012 591.823

  4. TreatmentCascade 2005 - 2012 68% 73% 53% ART Coverage : 31002/178631 = 17.4% Estimation of PLWHA 2012 = 591.823 HIV Treatment Monthly Report, 2005-2012. MoH RI

  5. HIV-AIDS Control Programs

  6. ARV Hospitals • Since 2005 • In all provinces • Complete services • Government and private hospitals 2005 2015

  7. ARV financing system • ARV is produced and procured since 2005 (locally and imported) • Fund source: national budget and GF-AIDS • The ARV budgeting is planned annually, integrated in national budget planning • The budget is managed by MoH: • Forecasting, planning, distribution  NAP • Procurement process  Directorate General of Pharmacy Service, MoH and VPP (GF) • MoH Indonesia is about to develop one gate policy for procurement

  8. ARV financing system • Minister of Health Decree: ARV is fully subsidized by central government since 2005 • Budget allocation from national funding is increasing 26.09 13.51 3.48 1.64 2.3

  9. ARV supply system • The ARV procurement is centalized, and involving MoH (NAP and Pharmacy), GF, Local and Global producers and National warehouse • ARV available: ZDV, TDF, FTC, NVP, EFV, LPV/r, d4T, ABC, ddI • The average cost for 1st line ARV treatment per patient per year 420 - 480 USD

  10. Global Producer Global Fund Voluntary Pooled Procurement National Warehouse ARV Supply System MINISTRY OF HEALTH Purchase Order LOCAL SASWaiver , Tax and Duty Exemption & Custom Clearance IMPORT NAP Bidding Process PHARMACY Local Producer – Kimia Farma

  11. ARV distribution system • ARV distribution system is centralized since 2005 • ARV decentralized distribution is started in 2011 and expanded gradually

  12. ARV distribution system - Centralized (4A) Delivery (2) Confirmation (3A) DO (1) Monthly report HOSPITAL NAP NATIONAL WAREHOUSE 3 months stock (3B) DO (4B) Delivery NAP WAREHOUSE

  13. ARV distribution system - Decentralized (4) Delivery (1) Monthly report (3) DO PROVINCIAL WAREHOUSE (2) Confirmation PHO 6 months stock HOSPITAL 3 months stock (5) Quarterly report (7) Delivery, quarterly (6) DO Quarterly NAP NATIONAL WAREHOUSE

  14. Advantages of current ARV supply chain management system Centralized ARV distribution: • Central government can directly control the ARV distribution in ARV hospitals Decentralized ARV distribution: • simplify the route  minimize ARV stock out in hospital • PHO has ownership in managing the ARV management • Involvement of the local CSO, to monitor the ARV management

  15. Challenges of current ARV supply chain management system Centralized ARV distribution: • Geographic  long route • More ARV hospitals, lack of human resource Decentralized ARV distribution: • Readiness of PHO, capacity of human resource • The existing logistic mechanism is vary among provinces (some are under disease program in PHO and some are under pharmacy program  need strengthening of coordination)

  16. Future strategic plans in scaling up ARV program • HIV testing acceleration: • Offering HIV test to pregnant women, TB patients, STI patients • Strengthening PITC implementation • Mobile clinic • HIV retesting for KAPs every 6 months • ART coverage acceleration: • Start ART • when CD4 count ≤ 350 • Regardless CD4 count for : pregnant women, TB-HIV patients, sero-discordant couple, KAPs, prisoners • Triple FDC • ART initiation at Primary Health Care

  17. Inventory and Order Management System (IOMS)

  18. HIV-AIDS and STI Information System

  19. Terima Kasih

More Related