May 6, 2021


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Indonesia courting controversy over private COVID vaccination program | News on the coronavirus pandemic

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Jakarta, Indonesia – The Indonesian government has approved a controversial new program that will allow private companies cashed in in this developing Southeast Asian country to pay to independently vaccinate their staff against COVID-19 and avoid the long wait for vaccination public.

The country aims to vaccinate 181.5 million of the 270 million people by 2021. But since the start of public deployment on January 13, only one million people have been fully vaccinated with two doses, according to Our World in Data , an online resource for tracking global COVID-19 immunization releases. Almost 2.7 million have had their first stroke.

“The reason we are doing this is to speed up herd immunity in Indonesia,” Health Ministry spokeswoman Dr Nadia Wikeko told Al Jazeera.

She says the program, which has already attracted 7,000 company members, “won’t leave the poor behind because private sector vaccines will come from ‘Gotong Royong,'” a new vaccine bank meaning mutual cooperation in Indonesian. .

Gotong Royong will be administered by Bio Farma, Indonesia’s only vaccine manufacturer.

“The cost of these vaccines will be borne by private companies that place orders. It’s just another part of the solution, ”she said.

Given global supply constraints, companies may offer a price premium in order to secure supplies, experts said. Bambang Heriyanto, a spokesperson for Bio Farma, said it was not clear when the vaccines would be imported into Indonesia, but discussions continued with Moderna and Sinopharm.

Mass vaccination campaign for journalists organized at Gelora Bung Karno sports complex in Jakarta [Mast Irham/EPA]

Most medical experts and epidemiologists in Indonesia are opposed to this plan.

“If the private sector is to help, it has to import vaccines and give them to healthcare workers and the elderly who are clearly more at risk than anyone,” said Ahmad Utomo, a molecular biology consultant in Jakarta specializing in diagnosis of the lungs. infections. “Or they could give them to the parents of their employees because most young workers in Indonesia live with their parents and have a much lower COVID-19 death rate. But this is a political decision, not a scientific one. “

Dr Dicky Budiman, an epidemiologist who has helped formulate Indonesia’s strategic response to pandemics for 20 years, says there are inherently high risks of involving the private sector in large immunization plans.

“A vaccine is a public good. It should have no economic value because the laws of economics – supply and demand – will prevail, ”he said. “We know that there is a huge demand for the vaccine and that this will introduce the possibility of counterfeit vaccines and unqualified vaccine distributions.”

Ethical concerns

Indonesia has suffered the worst coronavirus outbreak in Southeast Asia, recording nearly 1.35 million cases of COVID-19 and nearly 36,000 deaths since the first cases emerged last year.

The government has avoided strict lockdowns to curb the spread of the disease, fearing the effects on the country’s poor and is counting on vaccines to end the crisis.

The first phase of its vaccine launch for 1.3 million healthcare is complete. The second phase, intended for 38.5 million citizens, including nearly 17 million people in the public sector and nearly 22 million elderly people, was delayed due to insufficient stocks.

Dr Budiman recognizes that the private sector can play a role in immunizing the public, but its contribution must be based on science-based policy.

“The main goal of immunization is to reduce mortality by protecting those at greatest risk of death: healthcare workers, the elderly and essential workers,” he said. “But in this program, your qualification to be vaccinated depends on the fact that you are an employee of a company. It is not a public health strategy. It is an economic strategy. “

Dr Budiman adds that the program also risks undermining social harmony.

“Despite the benefits of vaccinating more people, it is a form of discrimination,” he said. “Rumors of first-class citizens and second-class citizens will crop up as soon as the program begins to operate.”

Indonesia says it will move forward with controversial plan to allow private companies to import vaccines – separately from public immunization program [File: Dedi Sinuhaji/EPA]

There is also concern about the capacity of the private sector to manage a public health program such as an immunization program. The list of the 7,000 applicant companies has been kept private, although Jahja Setiaatmadja, managing director of Bank Central Asia (BCA), one of Indonesia’s largest lenders, said in January that the bank would apply for the program.

“The fact that the government has formed this partnership with the private sector shows how ill-equipped it is to immunize the public,” Dr Budiman said.

Fithra Faisal Hastiadi, an economist at the University of Indonesia and spokesperson for the Ministry of Commerce, denies that the program signals that the government cannot meet its vaccination targets.

“The idea did not come from the government,” he said. “It was introduced by the Indonesian Chamber of Commerce and the government was rather reluctant to accept it at first, because every time you bring the private sector into the health sector, you get this kind of criticism.”

He says the program will be tightly regulated to prevent the emergence of a black market for COVID-19 vaccines.

“Right now we have a very limited number of vaccines in Indonesia,” he said. “It’s just a way for the private sector to help the government because it has the money to import more vaccines into the country. It’s not like you’re rich, you can get the shot because the companies that buy them have to give them away to their employees and families for free ”.

He adds, “Of course, companies that sign up will help themselves, because if they wait for the public rollout, it will take longer for them to vaccinate their employees. So it’s a market solution in a sense, but a rational one. The government will maintain strict control. “

Modified program

Andreas Harsono of Human Rights Watch Indonesia originally criticized the program when it was launched in January, saying the poor would be trampled on in the vaccine rush.

But now his office has given the green light to the proposal.

“They changed the rules, banning private companies from buying vaccines from the government, which means they would have to import themselves. This means that private companies will not be competing with the poor for the vaccines, ”he said.

Indonesia suffers from worst COVID-19 outbreak in Southeast Asia, with nearly 36,000 people dying from the disease in the past year [Adi Weda/EPA]

Wiku Adisasmito, spokesperson for Indonesia’s COVID-19 task force, said observers should “be careful when making comparisons, because every country has different demographics and geography, and the solution for every country will be different.” He adds: “And let’s be clear: no one will have to pay to be vaccinated. Each dose will be free. “

Indonesia is not the only Asian country to have reached an agreement with the private sector to speed up its vaccination process.

India, which shares equally difficult demographic, topographic, social and fiscal constraints for Indonesia, with just 0.2% of its huge population fully vaccinated, has signed an agreement with private hospitals to help with phase two of its vaccination campaign.

But with just 10,000 public vaccination centers nationwide and 20,000 private hospitals joining the program, the latter will soon be twice as numerous as public centers, according to local media.

And while vaccines will be free at overcrowded government centers where elderly applicants have had to queue all day to be served, private hospitals will charge between 300 and 400 Indonesian rupees, or about $ 5 per injection.

In the Thai seaside island of Phuket, where 80% of tourism-related businesses have closed, some of those that have survived have already acquired the Oxford-AstraZeneca and Sinovac vaccines, the only COVID-19 vaccines approved in the country, according to the South China Morning Publish the newspaper.

Phuket officials also plan to purchase 600,000 doses – as part of a separate deal from those already purchased by Bangkok – to gain herd immunity and reopen the island to international tourists as early as October.

In Bali, Udayana University virology professor Gusti Ngurah Mahardika urges public and private actors to do the same.

Indonesia’s mass immunization program started in January and is now entering its second phase [Made Nagi/EPA]

He says $ 200 million is all that is needed to acquire the six million doses needed to inoculate 70% of the population and achieve herd immunity. The figure, he calculates, equates to 5% of the $ 5.2 billion foreign currency tourists to Bali that contributed to the national economy in 2019.

“The biggest problem in Indonesia right now is the availability of vaccines because the government has limited financial capacity to buy the doses it needs to get herd immunity,” he said. “So if a private-public partnership allows more vaccines to be consumed in Indonesia, that’s a good thing no matter who takes them.”

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