1. Edo Agustian Indonesian Drug Users Network kornas@pkni.org Meaningful Involvement of PWID in Hep C advocacy in Indonesia

2. The national response to the prevention, treatment and management of hepatitis C (HCV) Late response, fragmented The Ministry of Health first established a national program focused on viral hepatitis in 2011, under the Sub Directorate for Gastrointestinal Infections and Diarrheal Diseases. People who use/inject drugs are disproportionately affected by HCV, and HCV-HIV co-infection Indonesia does not conduct routine national surveillance until 2015

3. Prevalence of HCV and HIV-HCV co-infection among people who inject drugs (2015) Source: National AIDS Commission, Ministry of Health Sub-Directorate of HIV and STIs & Sub-Sub-Directorate of Diarrhoeal Infections, Persaudaraan Korban Napza Indonesia (2014) Rapid Behavioural and Biological Survey. National AIDS Commission. Jakarta: Indonesia.

5. Barriers to HCV testing & treatment for people who use drugs in Indonesia: Prohibitive diagnostic test & treatment costs Lack of knowledge and awareness among community, general population and health workers People who use drugs are excluded from Indonesian National Insurance Health Scheme Lack of integration of HCV within HIV testing & care services HCV remains neglected in comprehensive harm reduction services, although should be key component according to UN guidance (Source: PKNI Monitoring Quality of Harm Reduction Services by community perspective) Stigma from health providers (many doctors refuse to treat active drug users or methadone clients)

6. Advocacy and community engagement Since 2011, PKNI has worked with drug users, policy-makers, and service providers to raise awareness about Hep C and ensure that the community is meaningfully involved in the national response. Highlights include: o In 2011, PKNI with ANPUD conducted study: Barriers to Hep C Diagnosis, Management and Treatment among PWID in 4 Asian countries o Training of harm reduction service providers across 9 provinces (2013) o Policy briefing on Hep C (2013) o Collaboration with Indonesian Liver Researchers Association and Ministry of health on public Hep C campaign (2013-14) o Collaborate with MoH in the national study (IBBS) and Rapid Survey: included Hep C and Hep B blood test for people who use drugs and Rapid Survey hep C and B test for all PWID (2014) o Peer Driven Intervention Study in Jakarta (2015) o Treatment price reductions and pharma advocacy (2014-present)

7. Peer driven intervention (2015) The meaningful role of the drug-using community is essential in addressing HCV 2014 WHO guidance recommends peer-driven interventions to address viral hepatitis among people who inject drugs Peer-driven intervention is an outreach model based on existing peer networks.In 2015 PKNI developed and implemented PKNI a peer-driven intervention among 326 active injecting drug drug users in Jakarta Aims: educate the drug using community on HCV knowledge, conduct community-based testing of HCV/HIV, and gain insights into barriers to treatment update Results will be published later this year.