Interview: Maura Linda Sitanggang – Director General, Ministry of Health, Indonesia

Maura Linda Sitanggang, director general at the Indonesian Ministry of Health, discusses the plans being rolled out to ensure that all Indonesians have access to medicines and how the Indonesian pharmaceutical industry has developed its self-reliance and innovativeness.

How does the Ministry of Health organize its priorities and how far along have you come towards reaching the initial goals since you assumed your position as director general last year?

“The universal healthcare system (JKN) has been as efficient partner as we could have hoped for.”

We have five priority goals within our responsibility. The first goal entails the access of medicines that we wish to guarantee for all Indonesians. In this regard, the universal healthcare system (Jaminan Kesehatan Nasional – JKN) has been as efficient partner as we could have hoped for. The social insurance of the people in Indonesia is of foremost importance as it provides us with the means to implement access to medicine for all. We work with two powerful tools to ensure our success: the national formulary for medicines and the electronic purchasing through e-catalogue of medicines.

The national formulary already encompasses more than 1,027 items, which is continuously updated and serves as a point of reference for all healthcare providers. The e-catalogue is under the supervision of the Public Procurement Agency of Indonesia (LKPP) and allows the hospitals and other public healthcare facilities to avoid long tender processes as it includes most of the medical products needed. Therefore, the process is simplified and thus more effective guaranteeing that the products listed in e-catalogue are compliant with the regulatory requirements.

The second goal consists of the control of medicines, which has been mandated to the National Agency of Food and Drug Control Indonesia (BPOM).

The third and the fourth goals are highly related, i.e. the improvement in quality of pharmaceutical services and the responsible use of medicines. In these priorities, we have been setting the pharmaceutical service standard required in the healthcare facilities such as national and international accreditations that are to be earned.

The fifth, and last goal, is centered on the securing the viability of the pharmaceutical as well as medical devices industries and the development of their viability. Indeed, the local manufacturer still has very low capacity when it comes to the active pharmaceutical ingredients (APIs) being 95 percent of the value consumed in Indonesia, were imported from countries such as China and India. We would like to encourage the national industry to become more innovation centered.

To achieve such an active investment in research and development, the Ministry of Health has designed a 15-year roadmap to transform the Indonesian pharma industry into an innovative industry. Could you expand on the construction of this roadmap?

This plan consists of three stages of five years respectively. We would focus on cooperation and transfer of technology in the first five years. The second period of five years would focus on acquiring and developing the technology, and the last five years would be to witness the local industries launch their own, locally manufactured products by mastering their own innovative technologies. And, overall, we would like to see the local companies invest higher percentages of their revenues into their R&D divisions.

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Now, this ambitious goal really requires a collaborative effort from the industry and the Ministry and we are aware of the fact that the requirements are high and extensive. However, we are dedicated to support the industry as best as we can. In this sense, we have installed a bottom-up information flow to directly gain inputs from the industry, while at the same time, the industry can easily have us take part in the challenges they meet and the successes they celebrate.

The pharmaceutical industry in Indonesia has steadily experienced annual growth rates of 7 percent over the last years and it is expected to double its size to reach USD 12 billion by 2020. What is the Ministry of Health’s strategy to foster the growth of the pharmaceutical industry?

Since the acceleration of the establishment of the pharmaceutical and medical devices industry is a presidential instruction, we have a roadmap for that as well. It has been established in dialogue with the JKN institution, the industry, and of course the other twelve ministries involved.

The role of the Ministry of Health includes providing support to the industry in its transition from a formulation-based to a research-based logic by the horizon of 2025. We encourage the industry in its efforts of the aforementioned technology transfer until they have the capacity to enhance their competitiveness further on their own.

The President of Indonesia, Joko Widodo, has the vision for 2015-2019 of a “Self-reliant, Equitable and Healthy Community” for Indonesia. What points does your strategic plan in the realisation of this vision comprehend?

As Ministry of Health we are of course focusing on the “Healthy Community” dimension of the set vision. And indeed, if we want to make a place for ourselves on the international scene, quality people and hence healthy people, is very needed.

We have a program in Healthy Indonesia through family-based approach, that was created in order to support the idea of a healthy Indonesian people. One is a programme for national immunization, targeting communicable diseases such as Malaria and HIV/AIDS. Another programme focuses on the access of essential medicines in public primary care facilities.

Counterfeit drugs are a major area of concern – just recently BPOM seized more than a thousand packets of counterfeit medicines worth USD 4.2 million in 32 provinces between May 30 and June 7 of 2016. How can the Ministry of Health fight this issue?

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Fighting the continuous rise of counterfeit drugs can only be done if we have a strong regulatory authority in BPOM and if all stakeholders, including law enforcement institutions and industry community work together to help maintain the strength. The Ministry of Health has developed a task force in that regard and be in charge of the policies enabling the strict control.

The upcoming Halal law is a matter of worries for many stakeholders in the pharmaceutical industry since pharmaceutical raw materials come from various sources and approximately 95 percent of the APIs consumed in Indonesia are imported from countries such as China and India. Many voices within the pharmaceutical industry have requested for the government to amend the law to exclude pharmaceutical products from this legislation to avoid a shortage of medicines. What can the Ministry of Health do to relieve the industry of its fears?

We have started to tackle this challenge early on, and are already very much involved in discussions with the Ministry of Religions. Since drugs are clearly not a commodity like any other, lives depending on them, we are bound to find a solution in implementation without hurting either the industry or the people reliant on drugs.

What is your main objective in relation with the pharmaceutical industry that you would like to accomplish in the next two years?

It is our goal to see the pharmaceutical industries improve their capacity and become truly innovative and competitive. The pharmaceutical industries in Indonesia have to become more research based and invest in technology for API and biological products. In the late two years, new investment on pharmaceutical industries or expansion of existing pharmaceutical industries have successfully grown in the country.

What do you want your legacy as director general of the pharmaceutical services and health devices at the Ministry of Health to be?

Although we have already achieved much in the last three years of the roll out of the JKN, we still have a long way to go. I strive to assure that we keep on following the right track and ensure the access to medicine for all Indonesians through smart policy handling. I hope very much that we will be remembered as being a dedicated supporter for the JKN, that worked efficiently and transparently to improve the access to high quality healthcare for healthy Indonesian people. At the same time, the pharmaceutical industries will continue to grow in Indonesia and transform from formulation-based to research-based industries resulting innovation and competitiveness in a global market.

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