international experts assess Indonesia’s International Health Regulation (IHR) core capacities

The COVID-19 pandemic underscored the need for countries to implement and improve IHR core capacities to prevent, detect, and respond to public health emergency of international concern at national and subnational levels. With its vast biodiversity and international travel connections, Indonesia faces risks of emerging infectious diseases (EIDs). 

To address this, the country conducted the first JEE in 2017. The evaluation aimed to identify the most critical gaps within Indonesia’s human and animal health systems to prioritize opportunities to enhance public health emergency preparedness and response capabilities. 

Embracing lessons learned from the COVID-19 pandemic, Indonesia remained committed to enhancing its health security and conducted the second JEE from 16 to 20 October 2023. Evaluators from Bermuda, France, India, Italy and international bodies visited facilities in Jakarta and Yogyakarta that play a critical role in responding to public health emergencies. These included animal health laboratories, reference laboratories, reference hospitals, points of entry, and emergency operation and coordination centres. The experts observed the facilities and discussed about their functions, strengths and challenges. The JEE team reviewed and discussed the evidence under the guidance of more than 120 Indonesian experts from relevant ministries, departments and agencies, and with diverse multidisciplinary backgrounds. Key development partners attended the JEE as observers.

“Since the first JEE and the lessons learned from the COVID-19 pandemic, Indonesia continues to improve health resilience and enhance our core capacities to provide better access, services, and affordability of healthcare for all Indonesian citizens. These efforts encompass the implementation of a health transformation agenda. The JEE holds importance in analysing and closing the gaps in preventing, detecting, and rapidly responding to public health threats,” said Mr. Kunta Wibawa, Secretary General of the Ministry of Health during his opening remarks.

The IHR JEE acknowledged Indonesia’s effective response to the COVID-19 pandemic, highlighting efforts such as establishing a task force, robust surveillance, widespread contact tracing, vaccination initiatives, and the development of comprehensive response plans. The team recognized achievements in implementing IHR, including legislative developments, the creation of a disaster pooling fund, and the establishment of a multisectoral disaster framework. Participants discussed the health system’s efficiency and quality, thanks to the SATU SEHAT application and integration of telemedicine. Indonesia’s progress in infection prevention and control, particularly through the establishment of a multisectoral risk communication and community engagement (RCCE) working group, was also highlighted. In addition, the evaluators commended Indonesia’s leadership in health security, pandemic preparedness, and the promotion of the One Health approach on international platforms such as G20 and ASEAN.

“We duly recognise the immense efforts that have been invested in the implementation of IHR core capacities across the country. These endeavours serve as invaluable lessons, and the coordination mechanisms across multiple sectors, spanning from national to primary healthcare centres, are truly commendable. Together, we have identified strengths and outlined a trajectory for continuous improvement, fostering preparedness and resilience against emerging threats and public health emergencies of international concern events,” said Karen Sliter, leader of the team of experts.

The evaluation team recommended Indonesia to expand and fast-track the digital transformation of the health sector to enhance efficiency, enable innovations, and generate evidence-based improvements. Along with accreditation of service facilities and services and balanced regulation to ensure optimal coverage and quality, other recommendations include standardizing and enhancing resource mapping for IHR implementation, establishing a review mechanism for inter-sectoral collaboration, reviewing the National Action Plan on Health Security (NAPHS), and intensifying IHR capacity building and coordination. In addition, Indonesia is advised to establish operational mechanisms for zoonosis and EID prevention, develop a roadmap for reducing risks in the wildlife trade chain, and expand cadre training for critical health programs, including zoonotic diseases.

The overarching recommendations and those specific to each technical area from the JEE will constitute invaluable inputs for the revision of the NAPHS and subnational action plans for health security, as well as Indonesia’s national medium-term and long-term development plans. Improving Indonesia’s IHR core capacities will not only lead to better health security preparedness, but will also bolster the country’s resilience and readiness in safeguarding the health and well-being of all people in Indonesia.

This activity is funded by the European Union.

Written by Dr Endang Widuri Wulandari, National Professional Officer (Epidemiologist), WHO Indonesia.