Promoting health, preventing illness
Interview with Budi Gunadi
Sadikin, minister of health, Indonesia
Indonesia is reimagining health care, shifting the focus from treating illness to promoting health, with bold reforms aimed at equity, preparedness and prevention How has the Indonesian government reformed its health system? When I joined the ministry in December 2020, the president gave me two tasks. The first was to save our people from the pandemic and the second was to reform the Indonesian healthcare system. In September 2022, we launched six pillars of healthcare reform: primary care, secondary care, healthcare resiliency, healthcare financing, healthcare human resources and healthcare technology. We also combined 11 antiquated laws into one single healthcare law in 2023, which laid the foundation for the whole reform.
What results have these reforms had so far? The biggest killers in Indonesia are stroke, heart attack and cancer. Every year our databases register 300,000 deaths from stroke, 215,000 from heart attacks and 234,000 from cancer. Based on my experience during Covid, the actual number is usually three times higher – so the number of deaths from stroke is closer to 900,000. Three million Indonesians die every year from these non-communicable diseases. If you manage stroke within two hours or a heart attack within six hours, the probability for the patient to live is very high. So we should have facilities in all 514 cities by 2037. When I started, only 44 cities had facilities for treating heart attacks. Can you imagine if you have a heart attack in Toronto and you have to go to Vancouver for treatment? Ridiculous! So with the grants and loans we have raised, we’ve increased the number of catheterisation laboratories from 44 in January 2023 to 129. But we won’t see significantly increased numbers of lives affected yet because we don’t have enough
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Health: A Political Choice – The Future of Health in a Fractured World
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