THE CHALLENGE

• Indonesia’s maternal mortality rate remains high and the country is at risk of failing to reach its MDG 5 target.
• Indonesia’s has one of the world’s largest TB burdens and the incidence of MDR TB is increasing. The HIV epidemic in Indonesia is among the fastest growing in the region.
• Indonesia’s rich biodiversity places it at special risk for newly emerging and re-emerging diseases originating in animals.

PROGRAMS   

In order to maximize impact, USAID programs focus on critical gaps and leverage points. This includes improving quality of services – clinical services in public and private sector facilities, and support services such as laboratories; leveraging information technology to improve effective demand and utilization of services; improving quality and use of evidence and information for policy and planning; building capacity of Indonesian institutions in health science and effective advocacy for evidence-based policies and programs; and improving governance at the district level in a highly decentralized health system.

MATERNAL, NEONATAL AND CHILD HEALTH

Under the GHI, USAID supports the Government of Indonesia’s goal of reducing maternal and newborn mortality and will contribute to a 25% reduction in maternal and neonatal mortality over the next 5 years.  This will be done by improving the quality of care in hospitals as well as improving Basic Emergency Obstetric and Neonatal Care in lower level facilities, improving the referral system, improving good governance practices, promoting the use of communication technology and social media to increase demand for and quality of services, and by reaching  underserved populations.  USAID also provides technical assistance to the national program for hospital accreditation,  prevention of malaria in pregnancy in Indonesia’s underserved eastern provinces, promotion of  zinc supplementation for child diarrhea, and  polio surveillance.

INFECTIOUS DISEASE

Tuberculosis

There are approximately 500,000 new cases of TB and 100,000 TB-related deaths in Indonesia each year. Increasingly, many of these cases are multi-drug resistant (MDR TB). USAID works closely with Indonesia’s National Tuberculosis Program to improve diagnosis and treatment of TB and MDR TB, strengthen community support for TB patients, and conduct local government advocacy for sustainable control programs.  USAID also provides technical assistance to Indonesian drug manufacturers to achieve WHO prequalification status, ensuring locally produced drugs meet international quality standards.  Under the GHI, these programs will contribute to the treatment and diagnosis of 1 million TB patients and over 5,000 MDR TB patients in Indonesia.

HIV/AIDS

The HIV epidemic in Indonesia is one of the fastest growing in Asia. To stem the transmission of the disease among most-at-risk populations, USAID provides technical support to government agencies and civil society to scale up integrated programs for HIV/AIDS prevention, care and to develop activities that lead to substantial, measureable behavior change. USAID provides additional technical assistance and small grants to develop organizational capacity to ensure the success of these activities. Additionally, USAID is also contributing to the National AIDS Commission-managed Indonesian Partnership Fund, that supports the development and strengthening of an effective and sustainable multi-sectoral response to the HIV epidemic in Indonesia.

Avian and Pandemic influenza

Since 2003, 178 cases of avian influenza (H1N5) in humans have been reported in Indonesia—the highest number of cases in the world. Indonesia remains at high risk for the emergence of a pandemic strain of the virus and is a key partner in the global effort to stem the spread of the disease from animals to humans. In partnership with other USG agencies, USAID supports a broad portfolio of activities to build Indonesia’s capacity to prevent and respond to virus outbreaks among poultry and humans, improve biosecurity measures in poultry farms, conduct disease surveillance, carry out behavior change and communication campaigns, and strengthen laboratories and research activities.

Emerging Pandemic Threats

Almost 75% of new, emerging or re-emerging diseases originate in animals. USAID’s EPT program seeks to identify early and respond to potentially dangerous pathogens in animals before they become significant threats to human health. The four components of EPT – PREDICT, RESPOND, IDENTIFY and PREVENT – seek to identify disease hot spots, improve Indonesia’s capacity to respond to disease outbreaks, enhance laboratory capacity for disease detection, and develop effective behavioral change communication strategies.

Neglected Tropical Diseases

125 million Indonesians are at risk for contracting lymphatic filariasis (LF) or elephantiasis, and soil transmitted helminthes (STH) or intestinal worms, are endemic throughout the country.  Under the GHI, USAID will help support Indonesia’s efforts to eliminate LF as a public health threat by 2020, as part of the global LF elimination strategy by reducing LF by 50% in 70% of affected populations.  In addition, USAID will provide technical assistance and support for the scale up of national distribution of medicines to prevent STH, contributing to 100 million treatments each year.