Laboratories are the backbone of a strong health system. They are the linchpin in disease surveillance, making sure health authorities can detect diseases early and prevent or effectively respond to outbreaks. This is particularly important with regards to measles and rubella, infectious diseases affecting children and young adults, which, when left untreated, can result in severe consequences, including loss of life. In Indonesia, a critical challenge emerged in recent years in the fight against measles and rubella: a shortage of reagents in laboratories needed for disease detection and surveillance. The lack of these essential laboratories supplies would hamper the country’s ability to accurately identify and monitor cases of these diseases, jeopardizing timely responses and risking negative health outcomes. As a measles and rubella endemic area, Indonesia’s performance in early case detection will also impact regional and global performance in eliminating the diseases.
WHO is actively supporting Indonesia’s efforts to control the measles and rubella disease burden by enhancing its public health laboratory system, including through the procurement of essential laboratory reagents. These reagents are indispensable in ensuring the success of Indonesia’s mission to eliminate these diseases.
The collaboration between WHO and the MoH has paved the way for Indonesia’s participation in the Global Measles Rubella Laboratory Network, which was established to provide high quality laboratory support for surveillance. The support includes trainings for laboratory staff, standardizing laboratory testing methods and protocols, assessing new technologies and reagents to support virus and case detection, and providing platforms for information sharing. Six laboratories in Indonesia are a part of the network and actively contribute to global efforts in measles and rubella control. These laboratories are Prof. Sri Oemijati National Reference Laboratory Network in Jakarta, Biofarma in Bandung, Balai Laboratorium Kesehatan dan Kalibrasi (BLKK) Yogyakarta, Balai Besar Laboratorium Kesehatan (BBLK) Surabaya, BBLK Palembang and BBLK Makassar.
In 2023, WHO procured 210 IgM Measles kits, 210 IgM Rubella kits, and 23 IgG Rubella kits. Each kit contains 96 tests, collectively allowing for more than 40,000 diagnostic tests. These kits are essential tools that help detect specific antibodies (also known as immunoglobulins) related to measles and rubella in blood samples, enabling healthcare professionals to determine whether an individual has a current or past infection with measles or rubella viruses.
MoH staff inspecting the box of reagents for quality checking. Credit: WHO/Tina Kusumaningrum
From June through to July 2023, WHO procured and distributed the reagents to the six laboratories that are part of the national measles and rubella laboratory network. This procurement enhances the capacity of these laboratories and reinforces their role within the network. Along with the procurement, WHO also provides technical assistance to help expand the laboratory network and enhance the overall quality and performance of the laboratories through the external quality assessment (EQA) programme.
The availability of these reagents empowers laboratories to swiftly detect cases, enabling healthcare authorities to respond promptly to outbreaks and implement targeted control measures. This crucial step protects vulnerable populations and curtails the spread of these infectious diseases.
By bolstering laboratory diagnostics, this collaborative effort between WHO and Indonesia lays the foundation for effective disease control nationwide. WHO will continue to work closely with Indonesia to enhance its health system and ensure a sustainable supply of reagents in the future, reinforcing their dedication to a healthier Indonesia.
The measles and rubella reagents in transit at the MoH’s cold chain facility (2-8 degree Celsius) before being distributed to measles rubella laboratories across the country. Credit: WHO/Tina Kusumaningrum
This activity is supported by USAID.
Written by Tina Kusumaningrum, National Professional Officer for Laboratories, WHO Indonesia.