Overview
In collaboration with provincial authorities, we developed and implemented an Evidence-Informed Deliberative Process (EDP) to translate international HIV treatment guidelines into locally legitimate priorities in West Java province. The process supported the Provincial AIDS Commission in developing its 2014–2018 strategic plan for HIV control.
Rather than focusing solely on expanding antiretroviral therapy (ART), the process structured deliberation around how treatment, prevention and mitigation interventions should be prioritised within limited provincial resources. The West Java case represents the first documented implementation of EDPs in HIV control and demonstrates how structured stakeholder deliberation can improve both the legitimacy and the evidence base of priority setting decisions.
Context & Objectives
Indonesia faces a concentrated HIV epidemic among key populations, with growing pressures on provincial health systems. West Java, one of the country’s most populous provinces, carries a substantial share of the national HIV burden. While national regulations expanded ART eligibility, provincial authorities faced difficult trade-offs between treatment expansion and other prevention and mitigation priorities under constrained budgets.
Previous strategic planning processes lacked systematic stakeholder involvement, explicit decision criteria and structured prioritisation. The reform therefore aimed to:
- Translate international HIV guidelines into context-specific priorities
- Strengthen stakeholder participation and transparency
- Improve the systematic use of evidence in decision-making
- Enhance the legitimacy of provincial HIV policy decisions
Approach & Methods Used
- The West Java AIDS Commission implemented the six-step EDP framework:
- Situational analysis, including epidemiological modelling
- Formation of a multistakeholder Consultation Panel (23 stakeholders from government and civil society)
- Selection of explicit decision criteria
- Identification of 50 candidate interventions
- Systematic assessment of interventions against agreed criteria: impact on the epidemic, stigma reduction, cost-effectiveness and universal coverage
- Structured deliberation adapted to local cultural norms favouring consensus
- Selection of funding and implementing responsibilities
The process combined stakeholder deliberation with evidence-informed evaluation to structure priority decisions.
Outcomes
Compared to previous planning cycles, both stakeholder involvement and the systematic use of evidence improved. Explicit criteria were used, trade-offs were openly discussed and broad consensus was achieved for the selected mix of treatment, prevention and mitigation interventions.
Key lessons include:
Priority setting should be iterative and supported by institutional development
Structured deliberation strengthens legitimacy in politically sensitive areas
Making criteria explicit improves transparency and consistency
The EDP framework is adaptable to local institutional and cultural contexts
Collaborating Partners
- Padjadjaran University
- West Java province AIDS commission