In the face of substantial hurdles, Indonesia has successfully integrated pneumococcal conjugate vaccines (PCV) into its routine immunization program. The journey, marred with complex circumstances, a favor for domestic vaccines, and concerns over feasibility and longevity, witnessed an initial delay in the launch and slow scale-up of the PCV vaccine. This was despite the significant burden of pneumococcal disease and its economic implications.
Overcoming Obstacles with Effective Collaboration
The Clinton Health Access Initiative (CHAI) partnered with the Indonesian government to offer evidence-based decision-making and implementation support beginning in 2017. This collaboration resulted in nationwide coverage by 2022. The road to this achievement was lined with challenges such as a devolved government structure, fragmented domestic funding, impending exit from Gavi (the Vaccine Alliance) support, and the lack of a domestically manufactured PCV product.
CHAI’s Role in Accelerating PCV Introduction
CHAI played a pivotal role in facilitating this significant public health milestone. They engaged with MOH Expanded Immunization Program (EPI) and efficiently coordinated meetings to expedite decision-making for PCV introduction. Furthermore, CHAI provided technical assistance at the subnational level, conducted readiness assessments, and supported training for health workers. These initiatives resulted in a high uptake of PCV and bolstered confidence in expanding the program.
Impacting Lives and Health Outcomes
The introduction of PCV is anticipated to avert thousands of deaths annually in Indonesia, where pneumonia is a leading cause of post-neonatal child mortality. The case study underlines the critical role of multi-stakeholder engagement and a tailored approach to overcoming challenges in vaccine procurement, distribution systems, and program sustainability.
The global health community has witnessed similar successes. For instance, Gavi has assisted in the vaccination of over 1 billion children in 78 lower-income countries, averting more than 17.3 million future deaths. Their current strategy aims to immunize 300 million children globally with routine vaccines, averting 7–8 million deaths, with a focus on reaching zero-dose children and missed communities.