IVI and Indonesia

 

Member State Relations

 

On October 28, 1996, the Ambassador of Indonesia to the United Nations Nugroho Wisnumurti signed the IVI Establishment Agreement.

 

Indonesian Leadership at IVI

 

Drs. Darodjatun of BioFarma was a founding leader of IVI and served on the Board of Trustees from 1995-2000.

 

From 2004 to 2009, Indonesian Ministers of Health, Professor Uman Fahmi Achmadi and Dr. I. Nyoman Kandun, served as Indonesia’s representatives on the IVI BOT.

 

Ongoing Collaboration

 

Capturing data on Antimicrobial resistance Patterns and Trends in Use in Regions of Asia (CAPTURA)

The IVI-led CAPTURA project played a pivotal role in expanding historical and current datasets on AMR and antimicrobial usage through extensive data collection efforts across Southeast and South Asia. Building on its successes, CAPTURA II aims to further improve the quality, quantity, analysis, and dissemination of AMR data. This phase focuses on refining methodologies in data collection, stronger monitoring of how surveillance systems are performing, better data management practices, and supporting sustainable improvements in these surveillance systems.

 

The project runs from 2023 through 2025, directly informing national and regional initiatives to help:

  1. Improve AMR surveillance
  2. Promote antimicrobial stewardship
  3. Shape evidence-based policy

 

Countries: Bangladesh, Bhutan, Indonesia, Laos, Nepal, Pakistan, Papua New Guinea, Sri Lanka, Viet Nam

 

Strengthening External Quality Assurance for AMR in Asia (EQAsia)

The Technical University of Denmark is leading a consortium with IVI and the Veterinary Faculty at Chulalongkorn University in Thailand with the Strengthening External Quality Assurance for AMR in Asia (EQAsia) project. During the first phase, the consortium identified and mapped coverage of external quality assurance programs on the continent, providing seven rounds of services and relevant trainings to National Reference Laboratories and Centers of Excellence across One Health sectors. In the next phase, launched in 2023, partners provide four additional rounds of external quality assurance to more than 80 laboratories and centers in Asia and support two countries in establishing national external quality assurance programs to build up their capacity to independently conduct One Health-focused external quality assurance.

 

Regional Antimicrobial resistance Data Analysis for Advocacy, Response and policy (RADAAR)

This initiative improves regional data sharing and analysis for use in AMR planning, policy, and advocacy. The project laid the groundwork to strengthen the capacities of low- and middle-income countries to translate AMR knowledge – from data and evidence to effective policies. In 2024, RADAAR initiated the Evidence-Informed Policy Network with the World Health Organization in Bhutan, hosted a series of policy webinars, initiated online training modules, and conducted a systematic literature review on the economic evaluations of AMR.

 

Countries: Bangladesh, Bhutan, Cambodia, Cameroon, Eswatini, Ghana, Indonesia, Kenya, Laos, Malawi, Nepal, Nigeria, Pakistan, Papua New Guinea, Senegal, Sierra Leone, Tanzania, Timor Leste, Uganda, Vietnam, Zambia, Zimbabwe 

 

Technical Assistance for Clinical Engagement – Asia (TACE Asia)

The TACE Asia project focuses on providing technical support to improve the use of laboratory services and generation of good quality and representative AMR and antimicrobial use data in the human health sector. This will be done through support for clinical engagement and training on the use of simplified protocols to generate AMR burden data in select Fleming Fund priority countries. Launched in 2024, the program is contributing to the use of data on clinical practice and decision-making, improving rational use of antimicrobials, promoting antimicrobial stewardship, and shaping evidence-based practice.

 

Countries: Bangladesh, Bhutan, Indonesia, Laos, Nepal, Pakistan, Papua New Guinea, Sri Lanka, Timor-Leste, Viet Nam

 

Technical Assistance for Data and Evidence Use (TADEU)

The TADEU project was launched to provide technical assistance to support data production and improve the use of AMR data and evidence, with a particular focus on the economic evaluations of AMR.

 

In 2024, the project:

  1. Developed a micro-costing tool to help governments plan future AMR surveillance by informing financial implications, sustainability, and outcomes of AMR surveillance.
  2. Developed protocols and tools to measure the impact of antimicrobial stewardship programs as well as the economic burden of AMR.
  3. Completed literature reviews on existing methodologies and frameworks for econometric modeling and quantifications for AMR economic burden and impact measurements of stewardship programs.
  4. Developed a technical guide for the Political Economy Analysis framework.

 

Countries: Bangladesh, Indonesia, Laos, Nepal, Pakistan, Papua New Guinea, Timor-Leste, Viet Nam 

 

Japanese Encephalitis

IVI is evaluating the protective effectiveness of the Japanese encephalitis (JE) vaccine by conducting JE disease surveillance in all 24 hospitals and health centers in Bali.

 

From 2003 to 2009, IVI researched the burden of JE in Indonesia. At field sites in Bali, Jakarta, Semarang, Yogyakarta, Manado, and Pondianak, IVI conducted JE disease surveillance, disease burden studies, and economic impact studies such as cost of illness and vaccine cost effectiveness. As a result of these studies, IVI discovered that JE is a serious problem in Bali, especially in children under 10 years of age.

 

IVI’s research led to a mass JE vaccination campaign in Bali in 2018. Funded and coordinated by the Indonesian Ministry of Health and Gavi, the Vaccine Alliance, the campaign saw over 890,000 Balinese children receive the Chengdu SA14-14-2 JE vaccine. 

 

Typhoid Vaccine Development

Since 2010, IVI has been developing a typhoid conjugate vaccine (TCV) with Indonesia’s BioFarma and South Korea’s SK Bioscience. IVI developed the TCV and transferred the vaccine technology to BioFarma and SK Bioscience in 2014. With funding from the Bill and Melinda Gates Foundation, IVI provided BioFarma with technical support for the technology transfer and clinical trials. In 2023, BioFarma’s Bio-TCV® was licensed for domestic use in Indonesia. IVI and BioFarma are continuing work to improve the vaccine’s formulation and to eventually apply for WHO prequalification. 

 

Previous Collaboration

 

Antimicrobial Resistance (AMR) Surveillance & Capacity Building

With support for UKAID’s Fleming Fund, IVI’s CAPTURA program worked with health authorities in 12 countries across central and southeast Asia (including Indonesia) to collect, review, and digitize AMR surveillance data. The project also helped identify gaps in data and areas for quality improvement that can be addressed in future initiatives to strengthen surveillance capacity. The information resources generated by the project will improve awareness, advocacy, policy, and interventions needed to combat AMR and antimicrobial misuse.

 

DOMI & ViVA: Typhoid

From 2003 to 2008, IVI worked with partners in Indonesia, China, Pakistan, India, Bangladesh, and Vietnam to determine the burden of typhoid fever in Asia and demonstrate the effectiveness of typhoid vaccination. Typhoid surveillance in Indonesia uncovered a significant burden in North Jakarta and demonstrated the need for a typhoid vaccine. As a result, IVI facilitated the technology transfer of the Vi polysaccharide (Vi-PS) typhoid vaccine to Indonesia’s BioFarma, and additional vaccine manufacturers in India and Pakistan.

In 2006, The Indonesian Ministry of Health issued a consensus statement on the need to expand typhoid vaccination and to introduce it in a phased manner, beginning with a pilot project for school children in North Jakarta. Using the Vi-PS vaccine, 4,828 children in North Jakarta received the typhoid vaccine in a school-based mass immunization.

 

DOMI: Cholera

From 2004 to 2006, IVI carried out epidemiological and economic studies on Cholera in Indonesia. The epidemiological studies showed that targeted immunization with an affordable and effective cholera vaccine is more rational that universal immunization, even in outbreak situations. Analysis of the results of several economic studies of cholera conducted at the IVI field sites was completed. The average cost of the cholera illness for hospitalized patients, including lost wages due to missed work by the patient or caretakers: $208 in N. Jakarta, Indonesia. Results of the study identified a considerable demand for new-generation cholera vaccines in low incidence areas.

 

DOMI: Shigella

From 2002 to 2005, IVI carried out its first global program, the Diseases of the Most Impoverished (DOMI) disease burden study. As part of DOMI, IVI investigated the disease burden of Shigella in Indonesia, Bangladesh, China, Pakistan, Thailand, and Viet Nam. In Indonesia, IVI established a study site in North Jakarta. In North Jakarta and other study sites, a total of 605,331 individuals were under surveillance and 56,958 episodes of diarrhea were detected, 2,927 (5%) of which were shigellosis. Data from studies showed that Shigella imposes a heavy economic burden on both public institutions and families, and identified a high demand for a vaccine against dysentery. The results of the Shigella study in Indonesia have major implications for the design of new vaccines and will influence the development of IVI’s Shigella vaccine.

 

Respiratory Pathogen Vaccine Program

From 2007 to 2011 IVI and Indonesia jointly collaborated in PneumoNet, a multi-country, hospital-based disease burden study in Asia designed to better define the incidence and serotype distribution of pneumococcal disease. Conducted jointly with Quintiles, Quest laboratories, and local hospitals, this study established surveillance sites in Indonesia, India, the Philippines, and Thailand. More than 20,000 children were enrolled in the 4 countries. Analysis of the data from study sites in Bandung, Surabaya and Bali demonstrated consistently high rates of pneumonia hospitalization in each case study population and helped make the case for the introduction of a pneumonia vaccine. Preliminary analysis of the data demonstrated a consistently high rates of pneumonia hospitalization in each case study population.

 

In 2012, IVI conducted landscape analyses of influenza in Vietnam and Indonesia, which involved developing an electronic platform for the collection and analysis of influenza data from Vietnam and Indonesia. This project was made possible by funding from the Yanghyun Foundation.

 

Rotavirus Diarrhea Vaccine Program

From 2004 to 2006, IVI collaborated with the Gadjah Mada University in Yogyakarta to estimate the disease burden and cost of treatment associated with rotavirus diarrhea in children. Study will also evaluate the cost benefit and cost effectiveness of immunization programs for rotavirus diarrhea. Data from the study was used to assess the value of rotavirus vaccine when they became available in Indonesia.

 

Supporting Independent Immunization and Vaccine Advisory Committees (SIVAC)

In 2010, IVI worked with the governments of Indonesia, Nepal, and Viet Nam to strengthen their existing immunization technical advisory committees by providing training and technical assistance. Capacity-building initiatives included sending delegates from Vietnam and Indonesia’s NITAGs to observe the Australian Technical Advisory Group on Immunization.