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
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 Funding
This 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.
This 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 Discussion
Total 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%.
In 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.
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