Vaccines as Public Goods
There is no need for a prolonged argument about whether Indonesia has lost the fight against the COVID-19 pandemic.
There is no need for a prolonged argument about whether Indonesia has lost the fight against the COVID-19 pandemic. It is also not necessary to be a master epidemiologist to show evidence that the government has been overwhelmed in dealing with the spread of COVID-19 throughout Indonesia. Entering the 10th month, the number of officially confirmed cases shows an increasing trajectory.
If in other countries the pandemic trajectory has decreased before rising again, in Indonesia the pandemic trajectory has never decreased at all. Indonesia is still in the first wave, which continues to climb with a death rate that continues to rise.
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At the same time, Indonesia is one of the countries with the lowest COVID-19 testing rate in the world. There are those who think it is unfair to say that all the problems of this pandemic are simply the result of mistakes by the Joko Widodo administration, because after all the community too has a role in the process of controlling the transmission.
However, it should be noted that a disease outbreak is a disaster that is slightly different from other types of disaster. Mitigating a disease outbreak requires a collective response that must be well organized and systematic.
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Only relying on public awareness at the individual level is not sufficient to reduce the rate of transmission that occurs through widespread social interactions. It means that the role of the government as the controlling holder of the public authority is crucial in mitigating a pandemic. The government\'s capacity to respond to any crisis that occurs is what determines the success of a country in the fight against the coronavirus.
A member of staff holds a phial of the Pfizer-BioNTech COVID-19 vaccine at the Southmead Hospital, Briston on December 8, 2020. - Britain on December 8 hailed a turning point in the fight against the coronavirus pandemic, as it begins the biggest vaccination programme in the country\'s history with a new Covid-19 jab.
During the last nine months since the first COVID-19 case was officially confirmed, the government seems to have stumbled in taking advantage of the opportunities that exist to reduce the rate of transmission.
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From the failure to close the airports and lockdown the city of Jakarta as the epicenter, to insufficiently tight restrictions on population mobility, especially in Java, there are many examples of the government\'s failure to understand the root causes of the pandemic until Indonesia finally became the country with the highest number of cases and deaths in Southeast Asia.
Vaccination preparation
Maybe now we can be a bit relieved because Indonesia has a new opportunity to control the spread of the coronavirus more effectively. The opportunity is the application of various types of vaccines made by several foreign pharmaceutical industries, especially from China. The central government\'s efforts to obtain vaccines from outside must be appreciated.
The process of getting vaccines in the near future is very competitive because Indonesia has to deal with developed economies, such as the United States, the United Kingdom, Germany and Sweden. To anticipate this, the Health Ministry issued a ministerial decree on Dec. 3, which regulates the implementation of COVID-19 vaccination throughout Indonesia.
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This is certainly good news that all of us should welcome. Moreover, the initial doses of Sinovac vaccine have arrived in Indonesia and are ready to be used awaiting approval from the Food and Drug Monitoring Agency (BPOM). Therefore, the COVID-19 vaccination program should be fully supported by all people. The problem is that there is something blocking the way the government regulates the COVID-19 vaccination program, and this could cause Indonesia to fail once again in dealing with the pandemic through vaccination.
This handout photo taken on December 6, 2020 and released by the Indonesian Presidential Palace shows the containers with the 1.2 million dosage of covid-19 vaccine made by Sinovac, on arrival from Beijing at the Jakarta International Airport in Tangerang.
Let us take a detailed look at the COVID-19 vaccination program that the government will carry out. According to the Health Ministry decree, the vaccination program is divided into two. The first program is carried out by the Health Ministry, in which the coronavirus vaccines will be given free of charge to more than 32 million people, which include health workers, public service providers and participants in the Social Security Management Agency (BPJS) Contribution Beneficiaries (PBI).
The second program is carried out by the State-Owned Enterprises (SOE) Ministry with a program titled "Self-sufficient Vaccines", which means vaccines are sold to groups who can afford them. The Self-sufficient Vaccines program targets more than 100 million people. We do not yet know what price people who are included in the Self-Sufficient Vaccines category must pay. Of course, it depends on the type of vaccines used, and herein lies the problem because the Self-Sufficient Vaccines program managed by the SOE Ministry could be described as the commercialization of vaccines, which is very inappropriate in the context of handling a pandemic.
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The main goal of vaccination is to achieve a level of collective immunity (herd immunity). Collective immunity is a condition that shows that all members of the community will benefit together because they are free from the disease outbreak. If there are still certain groups in society who are vulnerable to contracting COVID-19, this vulnerability will not only be a threat to that group or individual, but a threat to the entire community. Therefore, vaccines should be seen as public goods.
Ill-advised vaccine commercialization
Something is called a public good when it can be used by everyone without exception. If someone uses the item, no one else will be adversely affected. For example, streetlighting. Anyone can use it without having to pay because this electric lamp is provided by the government using tax money from citizens.
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The coronavirus vaccines are no different from streetlighting. Every citizen should have the same right to get the coronavirus vaccine for free through full subsidies from the government. This is what even neoliberal champion countries like the US and UK are doing, where the COVID-19 vaccines are provided for free to all citizens.
It is very strange that the Indonesian government should decide to carry out the Self-Sufficient Vaccines program. This program could add uncertainty to the COVID-19 vaccination process because there is no guarantee that every citizen who does not get the free vaccine can afford the cost of the vaccine.
Sulfikar Amir
In fact, the population target is very large. When this target is difficult to achieve, controlling the pandemic in Indonesia is at stake. This means that the Self-Sufficient Vaccines program is not only misguided in public health theory, but also irrational in public economic theory. And this program only shows the blunders of the government in trying to find smart solutions to control a pandemic that has claimed so many victims.
Will Indonesia fall into the hole of failure again?
Sulfikar Amir, Associate Professor and Disaster Sociology Expert, Nanyang Technological University.
