Sustainable Financing for New Vaccines in Indonesia: Challenges and Strategies

Abstract

Immunization is one of the most cost-effective interventions in global health and has a crucial role in achieving 14 of the 17 sustainable development goals (SDGs). The issue of sustainable financing for new vaccines is particularly pertinent as Indonesia transitions away from extensive Gavi support towards a self-financing immunization system. As the current immunization system transitions, practical solutions must be found and applied to provide more flexibility in the budget for financing immunizations without sacrificing the current healthcare system’s needs. Despite the fact that economic evaluation studies are essential as an initial step to ensure financial readiness, the lack of reliable data is the first barrier to Indonesia’s journey toward a self-financing immunization system. To overcome this problem, standardization of data collection strategies and methodologies are required. In particular, Indonesia may have to explore other options to increase revenue for its immunization system, such as through general revenue from the central government, a sector-wide approach to financing, and a national trust fund. To deal with the tight immunization budget and its consequences, Indonesia also has to restructure its immunization system, which can be implemented through province block grants, insurance mandate and subsidy. Taking the potential of a COVID-19 vaccine into account, the Indonesian government should consider a number of costs and issues beyond the development and procurement of vaccines. The costs of delivering vaccines to the remote parts of Indonesia, implementing the necessary infrastructure, and modifying vaccine delivery are also important in this time of transition. These constraints must be addressed in the new self-financing system and other public health efforts must be increased to decrease the burden of infectious disease as Indonesia develops a stronger immunization system.

Psychological factors affecting COVID-19 vaccine acceptance in Indonesia

“…However, this program is not without any obstacles. Lack of trained medical staff, problems in cold-chain storage and distribution, financial issues, and vaccine refusal or vaccine hesitancy are some of the issues that slow down the COVID-19 vaccination program [ 9 – 11 ].…”

Analyzing and visualizing global research trends on COVID-19 linked to sustainable development goals

“…Socially sustainable care systems that contribute better to fair using of health care in a post-COVID-19 era are of paramount significance due to the possible increase of chronic diseases in the future (Macassa & Tomaselli, 2020 ). In the case of developing countries, the priorities were concerned with: restructuring of public health systems to decrease the burden of infectious diseases, the establishment of sustainable financing programs for new vaccines, modifying vaccine delivery models mainly to remote zones, and the insurance mandate (Fonjungo et al, 2020 ). A further issue with concern in developing countries was related to investigating the threats of the pandemic on some SDGs, particularly poverty.…”

Exploring the Ethical Dimensions of Mandatory Immunization Discourse for School Attendance in Indonesia

“…Despite these challenges, vaccination is still one of public health efforts which has benefits that outweigh its economic spending. To overcome this, a sustainable self-financing immunization system and procurement strategies are suggested (54,57).…”