As COVID-19 cases continue to mount in countries around the world, Indonesia is a hotspot where cases quickly skyrocketed for several weeks. Just last week, Indonesia reported more than 2,000 deaths in a given day — a lagging indicator of the depths of the crisis it is facing. We also know from the devastating surge of cases in India earlier this year that the number of cases and deaths are likely an undercount, and in the weeks to come we’ll learn more about the virus’s true impact on Indonesia, the world’s fourth most populous country.
We had the opportunity to speak with Dr. Padmini Srikantiah, a Deputy Director with the Gates Foundation’s Global Health division. While she has pivoted to focus on COVID-19 response efforts in South Asia and Southeast Asia, Dr. Srikantiah leads the foundation’s Antimicrobial Resistance (AMR) strategy with a focus on preventing drug resistant infections in vulnerable populations
Gates Philanthropy Partner: Indonesia has emerged as a COVID-19 hotspot. Can you help us understand what is happening on the ground?
Dr. Srikantiah: Indonesia has experienced a massive surge in cases in recent weeks. The country has a large population, and at the peak they were reporting more than 50,000 cases a day — and that was likely an undercount. The surge is driven by the Delta variant, which is what we saw drive the surge in cases in India in April and May. We know that it’s more transmissible and that’s a problem for densely populated areas like Jakarta. While there has been a slight downturn in cases in recent days, the health system is stretched, with reports of hospital bed shortages in many parts of the country. Indonesia continues to report more than a thousand deaths a day.
Gates Philanthropy Partners: Indonesia is vast country. How does that impact the response to this crisis?
Dr. Srikantiah: Indonesia is an archipelago and many of the islands have limited health infrastructure. There is the potential for systems to be overwhelmed very quickly as cases rise. At this time, the majority of cases have been on the main island of Java, which is where the capital city Jakarta is — and high numbers of cases have also been reported on the neighboring island of Bali. Hospitals in the denser urban areas are facing severe shortages of oxygen, beds, and critical medicines and supplies. Our concern is that we’re going to see this ripple outward to areas that have far less of that infrastructure in the first place.
Gates Philanthropy Partners: Are vaccines reaching Indonesia?
Dr. Srikantiah: Here’s another case where the equitable distribution of vaccines is just so important. Yes, there are vaccines available in Indonesia, but the roll-out process is just starting. The government is a member of COVAX, which is the global entity helping to get vaccines into low- and middle-income countries. Additionally, the government has been working very hard to proactively procure more doses. As of this week about 16.5% of the population has received a single dose and about 6.6% have received both doses. But, as noted, Indonesia is a vast country with lots of islands, many languages, and a very diverse population so reaching all those eligible for vaccination will require a massive effort even as more vaccines are procured. And, like we’re seeing in so many countries including the United States, there is vaccine hesitancy and misinformation that needs to be addressed.
Gates Philanthropy Partners: How is the Gates Foundation supporting response in Indonesia?
Dr. Srikantiah: We are working to support Indonesia as well as other countries in the region with both emergency response and long-term planning. Specifically for Indonesia, we’re working on three levels. At the global level, we’re supporting Indonesia gain access to more vaccines through COVAX. We’re working with the Ministry of Health and the Ministry of Research and Technology as they have recently forged a partnership that is focused on disease surveillance and genomic testing. We’re supporting them with the scale-up of this effort. It’s really important that countries have the ability to detect variants and predict what might emerge in the future. We’re also working with partners like the World Bank that have made large loans to the country by providing technical assistance grants to support effective implementation of these COVID-19 response funds.
Gates Philanthropy Partners: What is keeping you optimistic?
Dr. Srikantiah: Science. We have learned so much about this virus in such a short amount of time. We’re more equipped now than we were a year ago. And, we have vaccines that are effective. That’s truly remarkable. That said, vaccine equity is what keeps me up at night. For us to really start to move beyond these country and regional outbreaks, we need to ensure countries have access to vaccines — and soon.
The other thing that keeps me hopeful is that this a real moment to shine the light on the importance of well-functioning public health systems. My heart goes out to everyone who has been impacted by this virus and my hope is that by investing in public health, in the people with this expertise, and in the data, that we can save lives and better prepare ourselves for the future.
If you are interested in giving to support the crisis response in Indonesia, UNICEF and the Global Fund are both well-established in the country and working closely with government and local partners.
Global Fund to Fight AIDS, Tuberculosis, and Malaria: https://www.theglobalfund.org/en/our-covid-19-response/
For those living in Indonesia, Lembaga Kesehatan NU (LKNU), is a grassroots health organization at the forefront of COVID-19 response efforts