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Commentary: Paying for vaccines in Indonesia stokes discontent given pandemic inequalities

In a climate of economic hardship, a special programme for people who have the money to buy vaccinations was always going to be unpopular, says a researcher.

Commentary: Paying for vaccines in Indonesia stokes discontent given pandemic inequalities

A city cleaner works near a large coronavirus-themed mural in Jakarta, Indonesia, Friday, Oct. 2, 2020. (AP Photo/Dita Alangkara)

SINGAPORE: Indonesia has become the new epicentre of the COVID-19 pandemic in Asia. As the number of deaths rise and the country’s vaccination rates continue to lag behind, even a small-scale programme to sell China-made vaccines privately has fallen prey to the politically charged atmosphere.

On Jul 21, Indonesia reported 33,772 cases and a record high of 1,383 deaths. In total, the country is seeing infections hitting 2.9 million.

It has reported fatalities of 84,766 thus far. Hospitals are turning away patients as beds, oxygen supply, and medicines run out.

People are collapsing dead on the street or on the way to, between or returning home from seeking a hospital bed. These are incidences documented by the investigative journalism Mulatuli Project.

A huge number of people must diagnose themselves and are in self-isolation, without assistance. Volunteer community kitchens are preparing food.

READ: Commentary: Overwhelmed Indonesian hospitals with COVID-19 cases behind high doctor fatalities

While an Emergency Micro Scale Social Movement Restriction (PPKM) Order has restricted mobility in some areas, it has failed to slow down the increase in cases, hospitalisations and deaths. Some reports now assess that half the population of Jakarta has been infected, and this is still growing.

Thus far, the government has been reluctant, or perhaps genuinely unable, to institute a full national lockdown. Hence, the logic of the situation points to the urgency of mass vaccination.

On Jul 13, Dedy Permadi, the Communications and Informatics Ministry spokesperson, announced a new target for vaccination. This would be increased from 181.5 million to 208.2 million. He added that Indonesia is accessing vaccines from China as well as from several other sources.

In that week, Indonesia received 17.8 million COVID-19 vaccines, bringing the total to 134 million doses. Indonesia’s population stands at 276 million.

READ: COVID-19 emergency restrictions in Indonesia extended until Aug 2: President Jokowi

STRONG CRITICISM OF PAID VACCINE SCHEME

To implement the mass scale of vaccination necessary, the government pursued two avenues – a national vaccination programme and a smaller scheme involving individuals paying for vaccines privately.

But the latter has attracted strong public criticism, adding to the discontent steadily accumulating around inequities and commodification involved in the handling of the pandemic.

People wearing protective face masks queue to receive a dose of China's Sinovac Biotech vaccine for coronavirus disease (COVID-19) during a mass vaccination program at a school building in Jakarta, Indonesia, July 26, 2021. REUTERS/Willy Kurniawan

Kimia Farma, the state-owned pharmaceutical firm which is connected to thousands of pharmacies throughout the country, announced on Jul 11 that individuals could buy a vaccination at their outlets under the Gotong Royong Paid Vaccine Individual programme. The company said it was receiving the Sinopharm vaccine and would be selling vaccinations using this.

This individual purchase programme is an extension of another programme, whereby private sector companies could buy vaccines to vaccinate their staff.

According to the Minister of Health, Budi Gunawan Sadikin, 1.5 million doses of Sinopharm had been made available to the company-sponsored programme – a small number compared to the 130 million or so doses in the government’s stock. Under this route, only 300,000 vaccinations have been taken up.

READ: Commentary: Indonesia’s company-funded vaccination drive boosts the national rate but has limitations

Similarly, the individual purchase programme is a small-scale endeavour that presents another route for Indonesians to get vaccinated.

But it has come under a fusillade of criticism. The country is already awash with reports of price wars for antigen testing. People are looking for places that sell polymerase chain reaction (PCR) swab tests. These tests come at a prohibitive price for an average income earner.

As a result, the criticism should not have been unexpected.

READ: Fear, stress, relief: How CNA's Nivell Rayda tested positive for COVID-19 as cases spike across Indonesia

The prominent economist and sometimes critic of the government, Professor Faisal Basri, called the decision “biadab”– barbaric and uncivilised. It was a criticism that was reported across the media.

University of Indonesia epidemiologist Pandu Riono and the Vaccine for All Coalition, comprising individuals and civil society groups, have launched a petition calling for the programme to be halted because it discriminated against those who could not afford to buy the vaccine.

The price was set at 321,660 rupiahs per dose with a maximum administrative fee of 117,910 per dose. This adds up to 450,000 rupiahs (US$31).

For a family group of four, this could eat up a good part, or even all, of a poor person’s monthly income. This is especially the case during a period where work can be hard to find, with businesses closed and fewer people on the street.

File photo of a woman wearing a protective mask in Bogor, Indonesia, May 7, 2020. (File photo: REUTERS/Willy Kurniawan)

Another coalition, The Civil Society Coalition, has echoed these criticisms. At a virtual press conference, its spokesperson stated that requesting payment for vaccines was illegal. They stated they would take the matter to court.

GOVERNMENT SUSPENDS THE PROGRAMME

The government has defended the programme, stating that paying for the vaccine is voluntary and that it would not affect the government’s provision of free vaccines to the wider population. It also explained that the programme would only use Sinopharm; other vaccines such as Sinovac, AstraZeneca, Pfizer and Novavax would be used for the government’s free programmes.

The government argued that the paid programme for individuals would help speed up vaccination programme so that herd immunity could be achieved. The decision to start the programme was in response to the slow take-up of vaccines through the company-sponsored route.

READ: Commentary: Indonesia’s vaccination policies seem to favour the young and rich

On Jul 12 – one day after Kimia Farma had made its individual purchase announcement – the company announced that the programme would be suspended until further notice.

Corporate Secretary Ganti Winarno explained that this was in response to high interest, requiring further preparation for registrations of vaccinations, as well as “many questions” in the public domain, requiring more time for “socialisation”.

On Jul 16, President Widodo announced that the programme was cancelled because of responses from the public.

The announcement did not come across as a surprise. In a climate of economic hardship for a majority of the population, and with the background of an ongoing trial of a cabinet minister for corruption concerning COVID-19 crisis welfare funds, announcing a special programme for people who have the money to buy vaccinations was always going to be unpopular.

In the aftermath of this controversy, the focus has now shifted to the President’s reluctance to implement a serious lockdown.

Max Lane is Visiting Senior Fellow at the ISEAS-Yusof Ishak Institute. This commentary first appeared on the ISEAS-Yusof Ishak Institute’s Fulcrum.

Source: CNA/el

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