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Jakarta Post

Six months on, health experts covet greater voice in pandemic response

Ardila Syakriah (The Jakarta Post)
Jakarta
Mon, September 28, 2020

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Six months on, health experts covet greater voice in pandemic response To the nose it goes: A medical worker takes a sample from a man’s nose during a COVID-19 swab test in Jakarta. (JP/Dhoni Setiawan)

T

he resignation of Indonesia's top doctor from the COVID-19 task force has prompted questions as to whether the government is seriously involving health experts in its pandemic response.

Urologist and professor at the University of Indonesia’s (UI) Faculty of Medicine, Akmal Taher, has tendered his resignation as the task force’s health division head, saying that he would continue contact tracing and testing -- two measures he believed as essential in curbing COVID-19 -- elsewhere.

"It's true that I have resigned [...] For me, tracing and testing must be absolutely improved and I believe this must be done at community health centers," he said in a discussion organized by the Center of Indonesia Strategic Development Initiatives (CISDI) on Saturday.

"These are things I'll do in any future place I work, because I think we haven't done them."

Indonesia’s testing rate remains low, with 0.10 tests per 1,000 people over a rolling seven-day average, lower than India's 0.71 and the Philippines' 0.31, according to data from ourworldindata.org as of Sept. 23.

Read also: Contact tracing the missing link in Indonesia's battle with COVID-19

Akmal did not immediately respond to a request for comment, but the former director of Jakarta-based Cipto Mangunkusumo General Hospital indicated that he disagreed with the current pandemic response measures.

During Saturday’s discussion, Akmal, despite acknowledging the government's efforts to accelerate testing for a possible vaccine, said that he personally could not make any promises about vaccines being soon developed given that clinical trials were still underway.

His remarks stand in stark contrast to the more optimistic outlook of some government officials who claimed a vaccine could be ready by December. A proven COVID-19 vaccine currently does not exist.

Akmal said it was "quite too early" for the government to start talking about vaccine availability, even if it only intended to remind people not to lose hope.

"The danger is that there are people who are misreading it," he said, suggesting that it could result in complacency over adhering to health protocols.

Read also: Efficacy and safety first: Experts urge government not to put vaccines on pedestal

Akmal's resignation came not long after President Joko "Jokowi" Widodo instructed his Cabinet members and agency heads – including Coordinating Maritime Affairs and Investment Minister Luhut Pandjaitan, Health Minister Terawan Agus Putranto and National Disaster Mitigation Agency (BNPB) head Doni Monardo – to focus on suppressing coronavirus transmission and death rates in the country's nine hardest-hit provinces.

Doni has been leading the national COVID-19 task force since March. Akmal was previously a part of the task force’s expert team.

In July, when the government formed the COVID-19 handling and national economic recovery committee to streamline strategic policies on countering the pandemic, Doni retained his position as task force head while Akmal was promoted to lead the task force's health division.

The COVID-19 response task force has since been put under the committee, along with the economic recovery task force led by State-Owned Enterprises Deputy Minister Budi Gunadi Sadikin.

Read also: Govt criticized for forming COVID-19 response team late in the game

Chairing the committee is Coordinating Economic Minister Airlangga Hartarto, with State-Owned Enterprises Minister Erick Thohir as its executive chairperson. Among its six deputy chairs are Luhut and Terawan.

Pointing to the military’s greater involvement in the country's pandemic response, a coalition of dozens of civil society organizations has demanded that the government hand back response efforts to public health experts.

Masdalina Pane of the Indonesian Epidemiologists Association (PAEI) said the task force had yet to properly implement existing guidelines and regulations on containing the disease, saying that it also had little experience in handling outbreaks.

Read also: Indonesian Military deployed for coronavirus fight

The COVID-19 task force, according to a list released in April, has 72 experts in fields ranging from medicine, public health and medical device technology to laboratory diagnostics and law. Three experts are epidemiologists and four are biostatisticians.

The expert team is led by Wiku Adisasmito, a professor at UI's School of Public Health and infectious disease researcher who was part of the National Commission for Bird Flu Control and Pandemic Influenza Preparedness (Komnas FBPI).

Wiku is also the COVID-19 task force's spokesperson, after having replaced the Health Ministry's disease control and prevention director general, Achmad Yurianto.

However, three expert team members from different fields who requested anonymity said that invitations to team discussions were often last-minute, resulting in experts not being able to attend. They also said their advice on postponing the regional elections was ignored.

Read also: COVID-19 now a real threat to year-end polls

One of the experts said that "probably three out of 10" suggestions were heard. Another expert said that the discussions were reactive as they were centered on issues that generated buzz among the public.

"I feel that, now, [discussions] emphasize economic interests. Discussions remain poorly planned," one expert said.

Meanwhile, Luhut, upon being assigned by Jokowi to oversee COVID-19 control in the nine hardest-hit regions, told a press briefing on Sept. 18 that he was assisted by many "bright, young people" including epidemiologists.

 

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