The Elders urge Indonesia to take bold steps to accelerate progress towards Universal Health Coverage


An article by The Elders

The Elders concluded a two-day visit to Indonesia with a call for the government to take bolder fiscal, political and social measures to accelerate progress towards Universal Health Coverage (UHC), building on impressive achievements in recent years.

Gro Harlem Brundtland and Ernesto Zedillo visit a health centre in Indonesia in November 2017 (Credit: Agoes Rudianto/The Elders)

Gro Harlem Brundtland and Ernesto Zedillo visited the Indonesian capital Jakarta on 28-29 November for meetings with President Joko Widodo (Jokowi) at the Presidential Palace, accompanied by Foreign Minister Retno Marsudi, Health Minister Nila Moeloek and Finance Minister Sri Mulyani.

They also visited the Kebon Jeruk Puskesmas (health centre) in west Jakarta, meeting patients, staff and local residents. The Elders also consulted with civil society organisations and held a briefing for local media.

Indonesia has the biggest single-payer health system in the world (covering 181 million people), and has committed to reaching full population coverage by 2019.

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The Elders congratulated President Jokowi on Indonesia’s progress to date. However they also expressed their concern about the fact that Indonesia’s rightly ambitious plan to achieve UHC is significantly under-financed. They suggested that without fiscal revenues stemming from additional general taxation, progress towards effective UHC could prove too slow.

The Elders also conveyed to President Jokowi and other high level Indonesian officials their worries about the high rate of tobacco consumption in the country. Higher taxes on tobacco could both deter consumption and provide more resources for health financing. In the longer term, they urged a modification of Indonesia’s policies on tobacco production to promote alternative, less harmful crops.

Gro Harlem Brundtland, Deputy Chair of The Elders and former Director-General of the World Health Organization, said:

“Indonesia has taken significant steps towards improving access to healthcare in recent years, and I am convinced President Jokowi can reach his goal of covering all the people of Indonesia by 2019, if the government commits further resources to the health budget. The level of public health financing and the overall tax yield is still too low to deliver effective public services; increasing taxes on products harmful to public health such as tobacco would be a step in the right direction.”

Ernesto Zedillo, Elder and former President of Mexico, added:

“The healthcare debate in Indonesia stands in stark contrast to some countries in the world, notably in the United States, that are moving away from universal coverage. Here, President Jokowi, government ministers and civil society are all trying to find ways to increase coverage and bolster social protection. I am encouraged by the meetings we have had here, and urge the authorities to be even bolder in committing greater resources to the health system, taxing harmful products and promoting greater accountability.”

The Elders believe Universal Health Coverage is the best way to achieve the overall health Sustainable Development Goal, and will join with civil society organisations and activists worldwide on UHC Day, 12 December, to promote their campaign so no-one is denied the healthcare they need because of a lack of financial resources.

(Thank you to Janet Hudgins, the CPNN reporter for this article.)