Institutionalizing NGOs in the public health system to response the HIV epidemic among IDUs in West Java, Indonesia Patri Handoyo Indonesia HIV/AIDS Prevention and Care Project

HIV Case in West Java Province Source: West Java Provincial AIDS Commission 2005

Risk Factors Source: West Java Provincial AIDS Commission 2005

Early Response (2004) None of government body responded Three NGOs started NSP in Bandung Underground program Considered as criminal activity Less than ten percent coverage

None of government body responded

Three NGOs started NSP in Bandung

Underground program

Considered as criminal activity

Less than ten percent coverage

Police Harm Reduction Program Together with provincial AIDS commission socialized HR to the police MoU of provincial police and AIDS commission was initiated A legitimate health institution needed to provide syringes

Together with provincial AIDS commission socialized HR to the police

MoU of provincial police and AIDS commission was initiated

A legitimate health institution needed to provide syringes

Provincial Public Health System West Java has primary health centre in every sub district (561) Three PHCs in Bandung City have been operating NSP since 2005 Political commitment by vice governor to scale up HR in 14 more districts The initiative involved district authorities to plan local HR program HR services were initiated in more than 30 PHCs

West Java has primary health centre in every sub district (561)

Three PHCs in Bandung City have been operating NSP since 2005

Political commitment by vice governor to scale up HR in 14 more districts

The initiative involved district authorities to plan local HR program

HR services were initiated in more than 30 PHCs

Bandung: Response to Province HR Scaling Up Plan Experienced NGOs were involved to build a city HR program Institutional role: NGO: enhancing PHC staff’s skill and involving community to the program PHC: delivering harm reduction service mainly NSP and basic health care City government: participating more PHC and building sustainability of the program

Experienced NGOs were involved to build a city HR program

Institutional role:

NGO: enhancing PHC staff’s skill and involving community to the program

PHC: delivering harm reduction service mainly NSP and basic health care

City government: participating more PHC and building sustainability of the program

Workshops and Trainings

Bandung 2006 Underground clients became public service clients NGOs are integrated to city HR program 12 PHC are operating NSP City health office lead the response

Underground clients became public service clients

NGOs are integrated to city HR program

12 PHC are operating NSP

City health office lead the response

HR recognized as a public health response run by local authorities

NGOs are not regarded as offender

Health care for IDUs widely accessible within communities