The Republic of Indonesia has successfully completed its second Joint External Evaluation (JEE) of International Health Regulations (IHR) core capacities. This marks a crucial step in strengthening its national health security systems. The JEE mission, conducted from 16 to 20 October 2023, reviewed 19 technical areas and developed a series of actionable priority recommendations that will inform the country's next five-year action plan.
Set against the backdrop of Indonesia's National Action Plan for Health Security (NAPHS) nearing its end in 2024, this recent JEE gains special relevance. Building on the foundation laid by the first JEE in 2017, which guided the NAPHS 2020-2024, its primary objective was to reassess Indonesia's capacities in these technical areas. The aim is to provide actionable priority recommendations, identify strengths and gaps, and understand and reflect upon best practices, all of which are crucial for aiding Indonesia's ongoing efforts to enhance health security.
"I would like to iterate our commitment to Indonesia’s health system transformation, aiming to advance the overall national public health security. With the ongoing National Action Plan for Health Security coming to an end very soon, it is only timely that the JEE was conducted. Its recommendations provide us with a concrete path for strengthening our preparedness, as well as our capacity to prevent, detect, and respond to any public health threats effectively," said Hon. Minister of Health Budi G. Sadikin in a meeting with the JEE team on 20 October 2023.
It is noteworthy that Indonesia's role in the global health landscape heightened further upon assuming the G20 Presidency in 2022. The country has been instrumental in shaping the international health agenda, focusing on transforming the global health architecture, sustainable energy transition, and digital transformation. Importantly, the Pandemic Fund was officially launched during Indonesia's G20 Presidency.
The JEE process is a peer-to-peer review. The evaluation facilitated by WHO is collaborative, involving external experts and host country experts who discuss and agree on all aspects of the findings, recommendations and final report.
The JEE brought together a multidisciplinary team of experts for a collaborative evaluation of Indonesia's abilities to prevent, detect, and respond to public health emergencies. The final scores and priority actions were a consensus between the Indonesian experts and the international experts assembled for this JEE, providing a holistic view of the nation’s health security landscape.
At the end of the JEE, the following overarching recommendations were agreed upon:
- Expand and fast-track the digital transformation of the health sector to improve efficiency, enable innovations and generate the evidence base for further improvements.
- Universalise the current programme of accreditation of service facilities and services with the right balance of regulatory mechanisms to ensure optimal coverage and quality.
- Utilise risk and evidence-based approaches for planning, prioritisation and resource allocation for health security strengthening.
- Foster the culture of joint reviews, assessments and simulation exercises to learn from emergencies that occur and prepare for emergencies that are likely to occur at all levels of the nation.
- Review existing public health functions and related regulations to enable context specific planning, development and maintenance of capacities for health security and health system resilience for emergencies at different levels.
The World Health Organization (WHO) emphasises that JEE scores are not the ultimate measure of a country’s health security.
"Scores are but a facet of the complex landscape of health security. What truly matters are the actionable insights that emerge from the JEE," commented Dr Karen Sliter, Team Leader for the team of external experts for the JEE Indonesia.
To effectively implement the priority recommendations, a multi-sectoral review of Indonesia's current NAPHS for 2020-2024 is needed to inform the development of the subsequent NAPHS for 2025-2029.
"Furthermore, temporal prioritisation of these priority actions for inclusion in the government’s annual budget plans, the development of an investment case for health security and organising a partners' forum to address resource gaps effectively," were suggested on behalf of the external experts by Dr Reuben Samuel, Programme Area Manager (CPI), WHO South-East Asia Regional Office (WHO-SEARO), and co-lead of the team of external experts for the JEE Indonesia.
The JEE mission in Indonesia comprised of members from 17 international organisations and sets a precedent for other countries, offering insights and lessons that contribute to global health security.