Indonesia Targets Strategic Purchasing of Health Services to Improve HIV Service Provision
In Indonesia, where only 59 percent of people living with HIV know their status, 20 percent of people living with HIV are receiving antiretroviral therapy, and just 1 percent of people living with HIV are virally suppressed, government leaders are looking to rapidly scale up citizens’ access to HIV services. This rapid scale-up, combined with projected declines in external financing support for HIV and limited domestic resource availability, has prompted government leaders to consider a variety of strategic health purchasing reforms for HIV service provision in Indonesia.
To support Indonesia in these efforts, HP+ worked with the Center for Health Financing and Insurance and the Ministry of Health’s HIV Subdirectorate to develop a set of policy recommendations to achieve better efficiency in the national health insurance scheme (JKN) funds currently spent on HIV. These recommendations build on previous HP+ analyses that showed how expanding HIV services through JKN could improve the efficiency, effectiveness, and sustainability of HIV financing by reducing reliance on input-based, supply-side financing from central and/or local governments.
In February, the technical working group presented a comprehensive overview of the HIV essential benefits package covered by the government, JKN, and donors; considered opportunities for payment mechanisms to improve HIV care and service delivery; analyzed current antiretroviral drug procurement practices to identify potential regulatory adjustments; and promoted policy dialogue among key stakeholders. Through a series of consultations, the group created the policy recommendations, highlighting key areas of improvement in strategic purchasing for HIV, and developed initial guidance for the innovative mechanism. These recommendations outline how government leaders can ensure optimal use of resources to achieve the country’s ambitious targets and successfully curb the HIV epidemic in Indonesia.