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AREA OF WORK
COMMUNICABLE DISEASES SURVEILLANCE
Country Issues and Challenges : Government of Indonesia (GOI) has changed her government system into a decentralized system which jeopardize the surveillance system of Communicable Diseases.
Expected Contribution :
- STIs surveillance strengthened
- HIV surveillance strengthened
COMMUNICABLE DISEASE PREVENTION, ERADICATION,
AND CONTROL
Country Issues and Challenges : Filariasis infection and transmission is endemic in many areas without adequate control activities. Pilot projects for Elimination of Lymphatic Filariasis (ELF) show encouraging results which need to be scaled up to provincial level, in line with the commitment to global elimination targets (Mekhong Plus). Dengue infection and its complications such as dengue hemorrhagic fever continue to increase in urban and periurban areas with increasing morbidity but encouragingly low mortality. Community participation and networking (COMBI) are needed to begin to control the transmission of dengue (esp. urban) and filariasis (esp. rural). Leptospirosis remains a serious although underreported threat. Rabies and Japanese encephalitis (JE) are serious focal problems that require support of the government system to strengthen control and vaccine prevention. Yaws and leprosy are treatable communicable diseases, but with serious focal transmission in poor, remote, underserved rural areas, which require strengthened awareness and support of the local government as well as the regional level. Helminthiasis is highly prevalent, highly endemic with serious chronic health effects that can be largely alleviated through sustained and recurrent mass deworming, which should be coordinated with ELF treatment wherever feasible.
Expected Contribution :
- Increase and sustain the quality of selected components and the areas covered by national programs to prevent, control, and eliminate targeted diseases, including Elimination of Lymphatic Filariasis (ELF), COMBI for dengue control and other arboviruses, anti-helminthiasis deworming, leptospirosis, rabies, yaws and leprosy.
MALARIA
Country Issues and Challenges : Malaria remains one of the major infectious diseases in large parts of Indonesia. Re-emerging threat has occurred in areas of previous effective control. Malaria morbidity and mortality significantly affects the poorer parts of the country. A strategic plan has been developed, together with increased funding recently approved through Global Fund for AIDS, TB, and Malaria, but implementation is yet to begin. Decentralization now underway mandates responsibility for implementation at district and provincial levels. The malaria unit of the MoH continues to need strengthening of its function as coordinator of both RBM and GFATM. Drug treatment policy needs continuing monitoring with regard to emerging resistance patterns.
Expected Contribution :
Increase and sustain the quality of selected components and the areas covered by national RBM partnership plan to be implemented under GFATM and other donor sources.
TUBERCULOSIS
Country Issues and Challenges :
Indonesia has developed and started implementation of a five-year strategic plan for TB control (2002-2006). There has been a marginal increase in case detection rates (CDR) for the past 2 years, as only Health centers have been implementing DOTS. In order to improve, other Public Health and Private institutions need to be involved in DOTS implementation. The quality of DOTS implementation, particularly, the recording and reporting system, presently suffers from several deficiencies, which need to be addressed by strengthening and streamlining DOTS activities at central, provincial and district levels. In order to provide sustained technical assistance to undertake these, it is essential to strengthen in-country technical support by augmenting staffing both at national and field level.
Expected Contribution :
- Improved implementation of DOTS services throughout the country, by establishment of effective partnerships, with health providers in other sectors (Public-Public Mix & Public-Private Mix), and provision of sustained technical support.
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