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When exchange rates decide who can get medical treatment
Because when exchange rates dictate the cost of medicines, they also quietly influence who can get medical treatment and who cannot.
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Breathe easy: Health workers administer a chest X-ray to a toddler on Feb. 22, 2025 at a Puskesmas (community health center) in Balikpapan, East Kalimantan, under a free TB screening program provided by the city’s health agency. (Antara/Aditya Nugroho)
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n recent weeks, the rupiah has slipped dangerously over 16,700 per US dollar, its weakest level since the pandemic, and almost reminiscent of the 1998 Asian Financial Crisis.
Analysts and commentators are rightfully alarmed. But as someone who works in the health sector, I find myself thinking less about forex charts and more about who might go without insulin next month.
When exchange rates dictate the cost of medicines, they also quietly influence who can get medical treatment and who cannot.
Indonesia imports around 85-90 percent of its pharmaceutical raw materials (APIs), mostly from China and India. This has long been the case, but when the rupiah tumbles, the consequences grow sharper and more immediate.
More than 1,400 generic drugs used in our national health system, from antibiotics to ARV to chemotherapy, depend on these imported inputs. The numbers are visible in the Health Ministry’s essential drug lists and reflected in national procurement platforms like e-Katalog.
And while the finished pills are produced domestically, their most important molecules come with a price tag set in the US dollar. A weak rupiah means one thing: everything costs more, but our national health budget does not magically grow overnight.
That gap between rising import costs and fixed public funding translates to delayed procurement, reduced stock and eventually empty shelves. For most urban hospitals, this is painful but manageable. For rural clinics and district hospitals, it can be disastrous.
