IVI and Indonesia

 

Indonesian support for IVI

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

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.

 

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 is providing BioFarma with technical support for the technology transfer and clinical trials. Biofarma completed phase I clinical trials in Jakarta in 2017, and Phase II and III trials are ongoing.

 

Japanese Encephalitis

From 2003 to 2009, IVI researched the burden of Japanese encephalitis (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. IVI is evaluating the protective effectiveness of the vaccine by conducting JE disease surveillance in all 24 hospitals and health centers in Bali.

 

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 Vietnam. 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) Initiative

In 2010, IVI worked with the governments of Indonesia, Nepal, and Vietnam 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.

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