A health worker in Solo, Central Java, interviews a visitor from outside the city on Wednesday. (Antara Photo/Mohammad Ayudha)

What Covid-19 Teaches Us About the Next Pandemic

BY :BUDI A. DJAFAR, DANIEL A. SIMANJUNTAK

APRIL 16, 2020

The lockdowns taking place all over the world due to the coronavirus pandemic have forced us to reflect on our roles in society and what we ought to do to anticipate the next pandemic.

Having observed how the crisis unfolded in Jakarta, Geneva and New York in the past month, we've earmarked policies that work and those that need rethinking. 

Before all else, a complete pause on all aspects of our lives is the only rational and effective way to battle the virus.

Countries that insisted on keeping their borders open or acted in haste to get people "back to work" too early have paid an enormous price with huge numbers of infection (and death), further delaying a return to normalcy.

The economic and social costs from a lockdown will undoubtedly be significant in what is already a declining economy.

The good news is that the slowdown is not a structural problem and short of a crisis of confidence.

President Joko "Jokowi" Widodo has already launched relief packages worth $27 billion – 2.5 percent of Indonesia's gross domestic product (GDP) – to help the poor and small businesses survive the pandemic. 

He has also suspended tax collection and shuffled resources inside the government to reinforce its Covid-19 mitigation efforts. 

The figure is small relative to what Singapore has spent (16 percent of GDP) and Malaysia (10 percent of GDP), but the government has hinted it might spend more. 

Once the dust settles, Jokowi will be faced with the task of rebuilding an economy that has turned out to be far from resilient and too vulnerable to external shocks.

Trade liberalization has meant our economy is now an integral part of the complex global production network, or the global value chains (GVC).

The drawback, however, is that our exports (and imports) become too dependent on other country's exports.

The time is ripe to rethink our industrialization strategy by fast-tracking local production capacities and gradually decoupling our dependency on regional and global supply chains.

The shortage of medical supplies – from surgical masks to ventilators – during this pandemic is a case in point.

Indonesia's industrial policy should be geared toward making local firms, including our state-owned enterprises, more resilient to global disruptions. 

Our access to drugs or vaccines for Covid-19 will be vital. There is generally no issue in mobilizing a globally coordinated response to Covid-19 but balancing the interests of pharmaceutical industries and public health is a whole different matter.

Competition and intellectual properties will pose serious challenges to getting hold of potential cures for Covid-19.

Incidents of countries and local governments competing for personal protective equipment (PPE) reminded us that access to testing kits, drugs, vaccines and medical technology to treat Covid-19 will remain a challenge. 

Even if new drugs or vaccines are found, clinically tested and declared safe for humans, there is still no guarantee we can get hold of them.

Effective multilateral arrangements, such as the World Health Organization's voluntary pool to collect patent rights, regulatory tests and data sharing, are welcome at this stage.

We should also not lose sight of our national legal framework to produce and distribute drugs or vaccines to those who need them.

One way is by enacting the non-voluntary licensing for technology and drugs as stipulated in Article 31 and 31bis of the Trade-Related Aspect of Intellectual Properties Act and Article 109 of the Indonesia Patent Act.

Shortages and the potential difficulty of getting equitable and affordable access to experimental treatments for Covid-19 (such as favipiravir and remdesivir) could justify the activation of non-voluntary patent licensing on some of these drugs.

Intellectual Property Rights (IPRs) regime and public health don't always go hand-in-hand.

Since the WTO Doha Round, efforts by developed and least-developed countries to improve their access to medicine under international trade rules are ongoing, albeit slowly.

Indonesia cannot rely on these trade rules exceptions alone; national legislation and strategies to produce or "repurpose" generic drugs for different illnesses are crucial in battling future outbreaks.

Inequality and lack of access to healthcare will define the global political landscape in years to come.

This is true in New York City, now dubbed the "second Wuhan," where the coronavirus has affected mostly blacks and Latinos – who are twice more likely to get infected than whites – living in poor neighborhoods like Queens.

There seems to be some correlation (not causation) between low-income earners and a high rate of infection.

Economic inequality and the lack of access to health services may exacerbate health-related issues or containment in time of a public health crisis.

The opposite, however, is happening in Geneva. Universal health care systems through private insurances and adequate social safety net during the lockdowns have enabled the public to practice "social distancing" with relative ease. 

Although Indonesians theoretically have access to "free" healthcare, in practice it's more complicated.

Our national healthcare system, BPJS Kesehatan, cannot deal with a deadly outbreak in the scale of Covid-19.

The central and provincial governments must restructure their healthcare systems and infrastructure, including upgrading our community healthcare centers (Puskesmas) and laboratories.

The Covid-19 pandemic confirms the need to integrate new mechanisms to deal with national emergencies.

For starters, a "stress-test" could be conducted regularly to assess our national capacity to manage resources across the different branches and bodies of government in times of emergency.

The Military and National Police do it. The central bank too has its own schemes to deal with various scenarios leading up to an economic crisis.

What the Covid-19 shows us is that a pandemic is almost always multidimensional and requires a coordinated response.

Simulations can weed out miscommunications among central, provincial and local authorities. This would ease the path to a more permanent task force. 

Learning from experience helps. China, Taiwan and South Korea had their fair share of experiences of pandemics in the past (SARS, MERS) and have since created agencies to anticipate the next potential threat. 

At the moment, there is nothing more pressing than to contain the coronavirus from spreading and to support our medical professionals. We are on the right track. But just like our effort to fight the coronavirus, we must be at full-throttle at every front, including at preparing for the next pandemic.

Budi A. Djafar is a doctorate candidate in economics at the New School for Social Research, New York. Daniel A. Simanjuntak holds a Master of Laws degree and lives in Geneva, Switzerland.
 

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