The Indonesian government has approved a controversial new scheme that will allow cashed-up private companies in the developing Southeast Asian nation to pay to independently inoculate their staff from COVID-19 and avoid the long wait for public vaccination.
The country is aiming to vaccinate 181.5 million out of the 270 million population by 2021. But since the public rollout began on January 13, only one million people have been fully vaccinated with two doses, according to Our World in Data, an online resource tracking global COVID-19 vaccination releases. Nearly 2.7 million have had their first jab.
“The reason we are doing this is to speed up herd immunity in Indonesia,” Ministry of Health spokesperson Dr Nadia Wikeko told Al Jazeera.
She says the scheme, which has already attracted 7,000 company members, “will not leave the poor people behind because private-sector vaccines will be sourced from ‘Gotong Royong’,” – a new vaccine bank meaning Mutual Cooperation in the Indonesian language.
Gotong Royong will be administered by Bio Farma, Indonesia’s only vaccine maker.
“The cost of these vaccines will be borne by private companies that place orders. It’s an additional part of the solution,” she said.
Given global supply constraints, companies may offer a premium on the price in order to secure supplies, experts said. Bambang Heriyanto, a spokesperson for Bio Farma, said it was not clear when the vaccines would be imported into Indonesia but talks were continuing with both Moderna and Sinopharm.
Most medical experts and epidemiologists in Indonesia are opposed to the plan.
“If the private sector wants to help out, they should import vaccines and give them to healthcare workers and the elderly who are clearly more at risk than anyone else,” said Ahmad Utomo, a molecular biological consultant in Jakarta specialising in the diagnosis of lung infections. “Or they could give them to the parents of their employees because most young workers in Indonesia live with their parents and have a much lower COVID-19 mortality rate. But this is a political decision, not a scientific one.”
Dr Dicky Budiman, an epidemiologist who helped formulate Indonesia’s strategic response to pandemics for 20 years, says there are inherently high risks of involving the private sector in large vaccination plans.
“A vaccine is a public good. It should not have any economic value because the laws of economics – supply and demand – will prevail,” he said. “We know there is huge demand for the vaccine and that will introduce the possibility of counterfeit vaccines and unqualified distributions of vaccines.”
Indonesia has endured the worst coronavirus outbreak in Southeast Asia, recording nearly 1.35 million cases of COVID-19 and nearly 36,000 deaths since the first cases emerged last year.
The government has steered clear of strict lockdowns to curb the spread of the disease, fearing the effect on the country’s poor and is banking on vaccines to bring the crisis to an end.
The first phase of its vaccine release for 1.3 million healthcare is complete. The second phase, aimed at38.5 million citizens, including nearly 17 million people in the public sector and nearly 22 million older people has been delayed because of inventory shortfalls.
Dr Budiman acknowledges the private sector can play a role in vaccinating the public but that its contribution should be based on science-driven policy.
“The main goal of vaccination is reducing mortality by protecting those at greater risk of mortality: healthcare workers, the elderly and essential workers,” he said. “But in this scheme, your qualification to be vaccinated relies on you being an employee of a company. It’s not a public health strategy. It’s an economic strategy.”
Dr Budiman adds the scheme also risks undermining social harmony.
“Despite the benefits of vaccinating more people, it is a form of discrimination,” he said. “Rumours of first-class citizens and second-class citizens will arise as soon as the scheme starts running.”