WHO/Endang Widuri Wulandari
7th COVID-19 Intra Action Review (IAR) hybrid meeting, 21-24 November 2022, Jakarta
© Credits
WHO/Endang Wulandari
Multisectoral stakeholders attended the hybrid IAR COVID-19 meeting.
© Credits
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7th COVID-19 Intra-Action Review: Embracing lessons learned from the COVID-19 response towards health transformation

21 December 2022
Highlights
Indonesia

Written by Dr Endang Widuri Wulandari

Despite the public desire to de-escalate the COVID-19 response towards a transition to reduced mitigation measures, the WHO Director-General concurs with the advice offered by the international Health Regulations Emergency Committee regarding the ongoing COVID-19 pandemic and determines that the event continues to constitute a Public Health Emergency of International Concern (PHEIC). There remains the risk of new variants which requires a coordinated international response.

As of 19 November 2022, 6 603 195 COVID-19 cases with 159 348 deaths have been reported in Indonesia. An increasing trend of COVID-19 cases and deaths was observed during October and November 2022, with the bed occupancy rate at an average of 12 %. As of 16 November 2022, BA.5 is the predominant subvariant circulating in Indonesia (37%). XBB (25%) and BQ1(26%) are also reported in Indonesia. Vaccination coverage for the overall population as of 19 November 2022 reached 75,98% for one dose, while the rate for those receiving two doses reached 63,74%.

Fig. 01.Mr Aji Muhawarman, communication bureau and public services Ministry of Health, presented achievements, gaps and challenges in COVID-19 risk communication during IAR (Credit: WHO/Endang Widuri Wulandari)
WHO has been supporting MoH in conducting an intra-action review (IAR) in August 2020 and regularly monitoring its recommendations. From 21-24 November 2022, MoH conducted the 7th IAR monitoring meeting in Jakarta.

Around 60 participants from across sectors at national and subnational levels attended. Participants represented health facilities, provincial health offices, Points of Entry, the National Disaster Agency, the Coordinating Ministry of Human Development and Culture, the COVID-19 task force and researchers from the national research agency, the University of Gadjah Mada, and development partners such as DFAT and USAID.

During the IAR, WHO presented the global COVID-19 situation, the IHR emergency committee recommendations, and the Strategic Preparedness and Response Plan (SPRP) 2022. The research team from the University of Gadjah Mada shared the scoping review and bibliometric analysis of the COVID-19 pandemic lessons learned. The MoH presented a COVID-19 situation analysis in Indonesia and previous IAR recommendations, and the COVID-19 task force presented the COVID-19 response plan, followed by a presentation for each of the COVID-19 response pillars:
  1. Preparedness and response coordination
  2. Surveillance, laboratories, and public health intelligence
  3. Vaccination, public health and social measures, and engaged communities
  4. Safe and scalable clinical care and resilient health systems
  5. Research, development, and equitable access to countermeasures and essential supplies. These include serosurvey, developing the COVID-19 vaccine in Indonesia and other research initiatives.
Highlighted recommendations from the 7th IAR include:
  • Review of the COVID-19 response plan, including preparation of the COVID-19 transition phase at the national and subnational level and contingency planning and exercises for surge cases.
  • Collaboration among stakeholders to improve logistic management and information sharing, supply management and stockpile mapping for surge capacity.
  • Development of post-pandemic surveillance strategy using multisource surveillance, including integrating ILI SARI sentinel surveillance for COVID-19, influenza and other respiratory pathogens, whole genome sequencing (WGS), surveillance and surveillance with a one health approach, and optimisation of surveillance data and risk assessment to inform public health measure decision making.
  • Maintain tracing and testing capacity, timeliness and completeness of surveillance reporting through refresher training and review meetings.
  • Coordination among programmes to maintain essential health services at primary healthcare and referral services and monitor telemedicine uptake.
  • Strengthening hospital readiness, including infection prevention control, case management, human resources, and medical supply and equipment for surge capacity through periodic assessment, development of hospital pandemic preparedness plans and exercises, and training.
  • Continue to improve COVID-19 vaccination coverage, including coverage for vulnerable populations such as the elderly, improving real-time vaccine stock reporting through refresher training and modelling for effective modelling planning.
  • Continue monitoring media, reviewing risk communication strategy in preparation for the pandemic transition phase, and developing and conducting advocacy at all levels. 
  • Strengthening the whole-society-approach for pandemic preparedness and response, including public-private partnership and community empowerment.
  • Adopting the Points of Entry (PoE) readiness tool and conducting periodic PoE readiness assessments for routine and emergency capacity at PoE.
  • Fostering research on the COVID-19 pandemic response and lessons learned.

Fig. 02. Anis Fuad from the University of Gadjah Mada presented a scoping review, and bibliometric analysis of the COVID-19 pandemic lesson learned during IAR (Credit:WHO/Endang Widuri Wulandari)

“The Intra Action Review COVID-19 is essential as a platform to review COVID-19 response, identify best practices and challenges and formulate recommendations to improve COVID-19 response and contribute to build back better for health transformation towards sustainable preparedness for a future public health emergency,” said dr Indra Kurnia Sari, MKes, Coordinator of Infectious Emerging Disease, Directorate Surveillance and Health Quarantine MoH.

The recommendations of the 7th IAR will guide the strategic COVID-19 pandemic response and help build back better country capacity preparedness and response for future public health emergencies. 

Multiple sectors participated in the IAR and agreed to implement the IAR recommendations, which will be monitored in the next IAR meeting in 2023. 

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The 7th IAR was funded by the European Union.