Logistic Management of Antiretrovirals in Indonesia

Abstract

Background: The escalation of HIV-AIDS epidemic needs a comprehensive control efforts including the treatmentstage. ARV is inevitably needed to control the development of HIV-AIDS infection. The availability and accessibility of ARVis crucial to reach the successful treatment. Objective: To identify the implementation of logistic management process inthe central level. Methods: Conducting in depth interviews with informants from AIDS and Infectious Disease sub divisionof the Directorate General of Disease Prevention and Control-MoH, Directorate General Pharmacy and Medical Devices,GF-ATM, and PT. Kimia Farma as the manufacturer of ARV in Indonesia. Data was collected in Jakarta during May-August2011. Result: Source of fund procurement of ARV drugs in Indonesia comes from the national budget and Global Fund.Kimia Farma is the only national manufacture of 5-drugs firts line of ARV, while second line ARV is import include rawmaterials of ARVs. Logistics management consists of planning, procurement and storage, and distribution. Conclusion:Logistic management of ARV in the central level has run in accordance to drug logistic cycle. Unfortunately, most rawactive materials and final second line of ARVs product were still being imported. The government has planned an exitstrategy to reduce the dependency on the donor funding. The report and coordination process among the government,PT. Kimia Farma and end user (hospitals) has not worked well and synchronized. Recommendation: The governmenthave to encourage the local pharmaceutical industries to be able to produce ARV, especially the second line. All relatedstakeholders should enhance good coordination through periodic monitoring and evaluation in ARV distribution processand human resources capability in reporting mechanism