A Comparative Budget Requirements for TB program based on Minimum standard of Services (SPM) and Budget Realization: an Exit Strategy Before Termination of GF ATM

Abstract

It has become a common issue that the Global Fund (GF) as one of the largest international donors to AIDS, Tuberculosis, and Malaria Program will immediately stop the funding. Data shows that in 2009 GF ATM support reached 88,8% while APBN funding just cover 11,2% of the total budget needed. Howev­er, APBN budget for ATM programs was significantly increased in 2012 which covered almost 30% of the total budget. Eventhough the increasing trend of ATM budget seemed at the central government level, how­ever the local governments will hold the key to the sustainability of the post- termination GF ATM FundingObjectivesThis study aimed to get a picture of the local government’s commitment as an implementing insti­tution to respond the financing needs specifically for TB programs.MethodsThis economic evaluation compared the amount of the existing budget of local governments and the amount needed based on the Minimum Standards of Services (MSS) of TB Programs. We sampled two district in west java that were Cirebon and Garut. The cost component calculated in these evaluation were: medicines, medical supplies, case findings, and administrative cost.Results and DiscussionTotal budget needed in Garut according to MSS amounted 2,5 Billion Rupiahs, whereas the total budget which has been alocated approximately 2 Billion Rupiahs. For those budget allocated in Garut, 90% of the total was supported by the Government then the rest of that was supported by GF. A similar trend showed in Cirebon, which was found a budget shortage amounted 700 Million Rupiahs from approximate­ly 1,6 Billion Rupiahs budget needed and 80% of those was sourced by The Government. The particular finding showed that prevention and case detection program in Garut still dominated by GF support which slightly above 65%. Otherwise, budget allocated for those Activity in Cirebon has been dominated by the government approximately 80%.ConclusionIn general, both Garut and Cirebon faced two common challenges in terms of financing the TB program. First, the high shortage between needs and budget alocated of the program becomes an important concern for addressing TB cases reduction in related district. The second is program’s sustainibility after termination of Global Fund, particularly for prevention and case detection programs. Therefore, it might be need a support from NGO or other related institution to advocate the local government and DPRD to allocate more budget for reducing TB cases.

Analisis Kebijakan Pembiayaan Program Pengendalian Penyakit Tuberkulosis di Provinsi Daerah Istimewa Yogyakarta

“…Provinsi dan kabupaten menyiapkan biaya untuk kegiatan di lapangan dan diperlukan persetujuan di tingkat nasional untuk target yang akan dicapai. 8 Kontribusi dari masyarakat di daerah juga harus mulai dikejar untuk membiayai pelayanan terpadu di masyarakat. 9 Kontribusi masyarakat yang direncanakan adalah dengan mengaktifkan kembali Program Gerakan Terpadu Daerah (Gerduda) TB dengan melibatkan masyarakat dan lintas sektor yang diketuai oleh individu di luar kesehatan.…”

Situasi Tuberkulosis di Empat Kabupaten Kota di Pulau Sumatera dan Banten

“…1,5 miliar. 4 Besarnya anggaran pengendalian tersebut membuat Indonesia memerlukan bantuan (hibah) dari pihak lain. Sejalan dengan program AIDS, TB dan Malaria (ATM), program TB memiliki ketergantungan terhadap donor dari Global Fund.…”

“…Hingga saat ini baru ditemukan satu studi tentang pembiayaan program TB di Kabupaten Garut dan Kota Cirebon. 4 Oleh karena itu, studi ini penting dilakukan untuk mengestimasi biaya pengendalian TB di masing-masing wilayah studi yang sangat diperlukan untuk perencanaan, penganggaran, pembiayaan dan evaluasi pelayanan TB. 7…”

“…20 Walaupun demikian, kebijakan nasional pemerintah Indonesia adalah bahwa setiap obat untuk kasus TB disiapkan oleh pemerintah pusat melalui APBN, sehingga alokasi dana obat ini pada faktanya tidak membebani pemerintah daerah. 4…”

The Influence of Decision-Making Quality on Perceptions of Foreign Grant Accountability

“…However, the government's budget has not been sufficient to handle this case, so it is still very dependent on foreign grants from GFATM (Global Fund AIDS Tuberculosis and Malaria). The Indonesian government's TB control budget for 2009--2012 only ranged from 11.2% to 34.7% compared to the funds contributed by GFATM (Setiawan et al, 2016). This phenomenon encouraged Indonesia, represented by the Ministry of Health of the Republic of Indonesia with two other Principal Recipients (PR) (the University of Indonesia (UI) and the Central Executive 'Aisyiyah (PPA)) to take part in the management of GFATM grants.…”