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Jakarta Post

Public health and Indonesia's foreign policy in time of coronavirus

Public health and Indonesia's foreign policy in time of coronavirus Passengers keep their distance while waiting in line at Depati Amir Airport, Pangkalpinang, Bangka Belitung Islands, on March 19. 2020. (Antara/Anindira Kintara)
Andrew W. Mantong
Jakarta   ●   Tue, April 7, 2020 2020-04-07 13:34 402 fc6853813033f564188675f8bd03cfe5 3 Opinion public-health,foreign-policy,Indonesian-foreign-policy,foreign-affairs,diplomacy,COVID-19,pandemic Free

On the issue of public health, foreign policy and international security agenda have been dominated by issues of infection epidemic and biological terror risk. There have been numerous research studies on the effects of epidemics and biological terror on security, economic burden, social fragmentation, peace missions and the risk of diseases used as a biological weapon. When trying to find a solution to the COVID-19 pandemic, the government should take into consideration these international dimensions.

The World Health Organization first called on countries to pay attention to global epidemics in 2001 during the 54th World Health Assembly, when it urged countries to improve disease surveillance and system monitoring at the national and regional levels. Responding to Ebola, monkeypox, West Nile virus and SARS, which originated in developing countries, developed countries rolled out mostly coherent policies in official documents regarding strategic plans for international relations, annual fiscal strategy and issuing a white book on foreign policy and trade.

In the context of international relations, public health could be seen as linked to foreign and security policies. In reality, global health problems must be seen as an effect of imbalance in global development. In the early stage of the fight against global disease, the first attempt was to secure the centers of growth from infection. Four decades ago, the British government ordered screening of immigrants possibly infected with HIV/AIDS. The same happened during the outbreak of SARS in 2003, when countries adopted a siege mentality and started to tighten their borders.

Experts on health problems and global security Collin McInnes and Kelley Lee said that countries were wrong to make decisions based on tightening their borders instead of focusing on efforts to promote a healthy lifestyle and poverty eradication.

Another issue compounding the problem is terrorism. Global attention toward bioterrorism was first captured in the 1972 Biological and Toxin Weapons Convention. Following the 9/11 attack, the WHO called on countries to step up their surveillance regime and preparedness.

Globally, the trend has given rise to securitization, if not, militarization of public health sub-areas such as surveillance, security of public facilities, contingency plans, stockpiling of vaccines and medical supplies and protection of medical personnel. Following the anthrax attacks in 2001, the US began stockpiling vaccine for smallpox. As a result, the world suffered from a shortage of smallpox vaccine and Cipro, the antibiotics used against anthrax. This further worsened global imbalance.

Post-9/11, countries began to realize that access to health care was one crucial aspect in national stability. Yet, the basic assumption remains that health problems could weaken states and that it could create conflict. In most cases, weak states are in fact the root of all problems: weak health infrastructure, collapse of the economy which in turn could result in social strife. The 2002 US National Security Strategy deems that public health is part of the infrastructure for democracy. Health assistance was conditioned upon adherence to good governance principles. Meanwhile, WHO programs in Bosnia-Herzegovina and in Maluku, highlight the assumption that health assistance is the foundation for trust and peace. In many other cases though, health assistance for peace purposes ended up prolonging conflict.

In a final analysis, health is a public good that could lead to security and prosperity and not only a tool for states to achieve their objectives.

Having said that, what should be Indonesia's foreign policy post COVID-19? First and foremost, the COVID-19 pandemic shows the weaknesses of international disease surveillance and system monitoring regimes, which also points to the fallacy in the application of health security logic in securing centers of economic growth. Future collective international efforts to deal with the problem should focus on anticipating the next pandemic, including in rethinking and reinforcing global governance.

On the national level, there is an urgent need to craft a new strategy by taking into account global public health governance as well as that of other countries. Part of this strategy is crafting guidelines for social distancing and healthy lifestyle in an effort to flatten the curve and improving transparency at the national level.

What we can learn from South Korea, Singapore and Japan is that success depended on state capacity, which relied on fiscal power, management of population data, and the use of information technology for public policy as well as public support and trust in the government. Based on these countries' experiences, the reliability of their institutional framework laid bare the weakness of the securitization of global public health and that state capacity and strong government is key to solving health problems. Countries that have weak penetration into civil society as well as having weak investment in public health are now struggling to deal with the pandemic.

Redistribution of vital equipment such as test kits for countries in a worrying situation such as Indonesia should be the priority of our foreign policy. If transparency and data are key elements in the fight against COVID-19, then distribution of test kits should be the main target of diplomacy. This requires a paradigm shift, in that health should be treated as a public good and not an object of business or national interest.

The shortage of health equipment, hoarding and speculation on commodities such as hand sanitizer, face masks and personal protection equipment is but a reflection of global imbalance and this should be the impetus for foreign policy makers to help solve the limited access to life-saving supplies during a pandemic. Economic imbalance is the stumbling block in an effort to craft a solution both at the national and international level.

Indonesia's foreign policy should be directed not only to control cross-border mobility, but also to make sure that once a vaccine is ready, the country should get access to enough of it. Indonesia should not be sidelined because the global public health regime doesn't work well.

The generic solution of quarantining regions to stop the spread of COVID-19 resulted from the absence of global synergy as well as weaknesses in anticipating the spread of the disease. We need to fix this. All countries must reinforce not only their surveillance and monitoring system, but also the public health transparency, as part of their responsibilities as members of the international community.


Researcher, International Relations Department, Center for Strategic and International Studies (CSIS). The original article was published in CSIS commentaries.

Disclaimer: The opinions expressed in this article are those of the author and do not reflect the official stance of The Jakarta Post.