TEMPO.CO, Jakarta - THE year 2020 is about to end and now the big question is: will Indonesia emerge from the pandemic any time soon?
Vaccines have been developed, but epidemiologists have warned that they are not the only solution to the pandemic. Because the procurement and distribution of vaccines will not be easy, the public will have to continue to wash their hands, socially keep their distance, and wear masks, known as the '3M&' strategy in Indonesian. The obligation of the government to carry out mass testing, tracing of those who are infected, and treating the sick, known as '3T', must continue alongside the vaccination process.
It is these 3M and 3T strategies that have not been properly implemented in the last 10 months. According to a survey carried out in October, only 63.3 percent of people always wear masks outside their homes, while only 46 percent consistently perform social distancing and 55.5 percent wash their hands.
It is the same story with the 3T strategy. World Health Organization (WHO) guidelines call for mass testing of at least one person per 1,000 head of population per week. With a population of 270 million, Indonesia should be testing at least 270,000 people every week. As of the end of December, only 11 provinces were meeting this WHO standard.
Tracing is also lacking. As of November, the average ratio of tracing to isolation in Indonesia was 1:2. Only a few provinces had a better ratio. This means that the government is only able to trace two people for every patient confirmed positive with Covid-19. In order to break the chain of transmission, according to the WHO standard, there should be tracing of at least 30 contacts.
In the middle of all of these problems, the sacrifices of the people named as Tempo's Persons of The Year in this edition, are very valuable. They are the health care workers, the volunteer activists tracing Covid-19 patients, epidemiologists, laboratory analysts and virus researchers. Not all of them are affiliated with the government. However, what we frequently found is that in the face of various disasters, ordinary people work more quickly than government officials.
It is true that not a single nation in the world was ready for this pandemic. But Indonesia is an example of an extreme lack of preparedness. The government has been reckless and has lacked direction. Coordination has been in shambles. The president seems to be undecided between tackling public health and saving the economy. At one moment he asks for the pandemic to be wiped out, and then allows people to travel freely. It is as if every problem is looked at from the point of view of somebody who is unable to see the big picture.
The establishment of ad hoc bodies has not been accompanied by a clear division of responsibilities. The Covid-19 task force was set up, but with its hands and feet tied. The task force was dependent on the ministry of health and regional governments for funding and operations on the ground. When the National Covid-19 and Economic Recovery Committee was established, the same thing happened.
Not only simply replacing Minister of Health Terawan Agus Putranto - something which was done better late than never - the President needs to change his perspective on the importance of primary health care services. This refers to a health system that prioritizes basic health services, health promotion, and prevention of disease.
Health Research 2013-2018 shows the impact of the failure of these primary health care services. The number of people suffering from stroke, diabetes, cancer, and kidney disease in Indonesia has continued to rise - even long before the pandemic. The causes are a large number of smokers and obese people, insufficient consumption of vegetables and fruit and other nutritious food as well as a lack of physical activity. When Covid-19 struck, these vulnerable people were the main victims.
When strengthening the ranks of the doctors to treat those who are sick, the ministry of health ignored the preventative aspect. Public health centers, the vanguard of public health services, were ignored. The solution to the problem that the health ministry could not communicate effectively with these community health centers - simply because they are under the control of regional governments - was not sought after.
The Covid-19 pandemic should spur on changes to our public health system paradigm. Of course, we have hopes for Budi Gunadi Sadikin - the new minister of health - but more than that, we hope that this change can be initiated by President Jokowi.
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