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Efforts to contain the spread of HIV/AIDS in the country have been hampered by the decentralized health care system, National HIV/AIDS Commission secretary, Nafsiah Mboi, said on Wednesday.

“We have different epidemic levels and an uneven response because of the decentralized authority as we have to depend on each region’s development priorities,” she said in a forum organized by the European Union.

She said that even though all the country’s 33 provinces had allocated regional budget funds for curbing the spread of HIV/AIDS, the implementation remained ineffective as most of the money was used to raise public awareness instead of real action.

She said Papua had the highest prevalence of the disease and was estimated to have affected between 0.52 and 2.10 percent of the population, while it was relatively low in most parts of Java and in some parts of Sumatra where prevalence was between 0.04 and 0.10 percent.

“Working in a decentralized health system is not easy,” Nafsiah said, referring particularly to the period from 2006 to 2008 when the estimated number of people living with HIV/AIDS rose from 190,000 to 270,000.

She said there were 23,632 people reported to have been infected with the epidemic and that it was only the tip of an iceberg, accounting for fewer than 15 percent out of the total estimated number of infected people nationwide.

“This year we are going to review all the national programs we’ve carried out for the 2007 to 2010 period,” Nafsiah said, adding that the review would be used to improve the program for the 2010-2014 period.

The European Union ambassador to Indonesia, Julian Wilson, said that the European Commission’s cooperation focus in the health sector with the country had to be reformed with the emergence of infectious diseases such as the avian flu and on leading poverty-related diseases such as HIV/AIDS, tuberculosis and malaria. “The EC is particularly concerned about the epidemiological situation of HIV, TB and malaria in Indonesia,” Wilson said, noting the HIV epidemic among drug users and general epidemic among Papuans.

The country is a recipient of funds from the Global Fund to Fight AIDS, Tuberculosis and Malaria since 2001 which amounted to Rp 1.3 trillion ($137 million) in grants including an additional grant of $370 million this year, Wilson said.

Complementary EC funding worth Rp 132 billion had also been provided to three nongovernmental organizations to work with local partners such as IMPACT in West Java whose project focused on HIV among needle sharing drug users.

Bachti Alisjahbana, the head of the IMPACT team in Bandung, said that 92 percent of the intravenous drug users in the city were males who started injecting drugs at the age of 14 or 15.