On March 13, Wiku Adisasmito—a prominent professor of public health at the University of Indonesia and an adjunct professor of infectious disease and global health at Cummings School—was appointed head of Indonesia’s COVID-19 Rapid Response Task Force.
Adisasmito now directs and expedites all measures in the fight against COVID-19 in the Southeast Asian country, coordinating government bodies through the National Disaster Mitigation Agency and directly answering to the president.
Indonesia represents one of the most challenging fronts in the war against COVID-19. The world’s fourth most-populous country, Indonesia is home to 280 million people, spread out over a large archipelago of more than 10,000 islands. Within a month of the country reporting its first two positive cases, that number had skyrocketed to more than 1,000.
Controlling the spread of COVID-19 and flattening the curve there will not be easy. Indonesia’s national economy largely depends on agriculture, and any plan must account for the many field workers who depend on daily wages.
Yet the fight must also address the behavior of urban citizens. In Jakarta, Indonesia’s massive capital, for example, people have been using public disinfectant-spraying booths that provide no real protection against COVID-19 but can cause lung, eye, skin irritation, and possibly even skin cancer.
A veterinarian and epidemiologist by training, Adisasmito is no stranger to infectious diseases that spill over from wildlife to humans, nor the cooperative and holistic approach required to beat back this type of outbreak.
He spearheaded the Indonesia One Health University Network as part of One Health Workforce, a program funded by the U.S. Agency for International Development program, led jointly by Cummings School and the University of Minnesota, which is designed to increase international capacity for preventing and responding to pandemics like COVID-19.
Tufts Now talked to Adisasmito about leading the response to COVID-19 in Indonesia.
Tufts Now: How does the COVID-19 Rapid Response Task Force operate?
Wiku Adisasmito: The task force is directing what’s essentially a civil-military operation. And this war on COVID-19 requires ongoing communication and cooperation among the many various public sectors in Indonesia—including the ministries of human culture and development, health, finance, foreign affairs, criminal affairs, maritime, and investment. To avoid economic crisis and social unrest, we must work closely together to weigh public health measures and policies against their economic and social implications.
As the person tasked with providing the strategy and technical expertise around controlling the outbreak, I have access to the best resources in Indonesia, the United States, and across the globe. I can tap into the knowledge of all the medical associations, public health institutions, and specialists in infectious disease, clinical care, and pediatrics working to stop this pandemic.
And I’ve been able to utilize all the resources we have been building through the work of the Indonesia One Health University Network and the Southeast Asia One Health University Network.
However, we need the support of other partners, not just at the central and national level but also at the province and local level. The task force has been given oversight of the military and the police to help decentralize command of the response, and we’re working quickly to establish that structure. Regional task forces are headed by the national government and advised by the local-level chiefs of police and army, mayors, and district heads.
What is your approach to fighting COVID-19 in Indonesia?
Indonesia is limiting the physical movement of people from one area to another. We plan to quarantine citizens returning from other countries to limit potential transmission of virus. We also have required employers to have employees work from home whenever possible.
As prevention is the best weapon available against COVID-19, we are enlisting the media to explain the serious risk to the public and to communicate the best practices for people to protect themselves. Our primary focus is on promoting the critical importance of social distancing and physical distancing.
In Jakarta, for example, Muslims pray together in close proximity several times daily—and a public-health campaign is asking them to ensure they modify these social interactions to limit the risk of spreading the virus. We also working to help citizens understand that they need to wash their hands frequently and thoroughly, as well as to avoid touching their eyes, nose, and mouth.
The task force is establishing emergency hospitals for specifically treating patients with COVID-19. In central Jakarta, we have transformed a former athlete village into an emergency hospital with more than 2,000 beds. Outside Jakarta, an emergency hospital with 450 beds is nearly ready on Galang Island. Another emergency hospital on Sebaru Island near Jakarta is planned.
At the same time, we are trying to educate people not to visit the hospital unless it’s absolutely necessary. Hospitals can be a source of infection. Our health-care workers also soon will be stretched, and we need to ensure that doctors and nurses can care for the patients who need them most.
Why do we need a One Health response to COVID-19?
We will never achieve global biosecurity unless we can work together across countries to prevent infections that originate in animals. Even with this COVID-19 pandemic, most of the world seems to have forgotten the question of where it even came from and are now just talking about the human impact. They are missing the point that COVID-19 originated in animals and transferred to humans.
As we watch the furious spread of this virus across the globe, that lack of awareness makes me very afraid. We are not prepared for a second wave of this same virus or some other zoonotic disease that jumps from animals to people. We need to take a One Health approach to our COVID-19 response and investigate what is happening on the animal side and how this disease transferred to humans. That is critical both for Indonesia and the rest of the world. Otherwise we are just extinguishing the fire without knowing its source.
How is Tufts helping this effort?
With all the resources and my connections both in Indonesia and internationally, I can always call for help when I need it. And Cummings School professor Saul Tzipori is one of my best connections. We have been working together for a long time, and we have plans underway for other substantive collaborations.
One of my collaborations with Saul has come into play for the COVID-19 crisis: the One Health Laboratory Network (OHLN), a project that we developed together between Indonesia One Health University Network and Tufts University.
With funds from the U.S. State Department Biosecurity Engagement Program since 2017, we established a network to link all academic and government diagnostic labs in Indonesia, involving many relevant ministries. The OHLN project will improve our first and second line of defense against COVID-19 by incorporating all the human and animal laboratories in Indonesia for detection of the virus.
Shortly, hundreds of labs—possibly even as many as a thousand—will be available to help screen and identify COVID-19 patients for treatment—which also will allow for the rapid contact tracing and isolation so vital to cutting off the chain of transmission.
Genevieve Rajewski can be reached at email@example.com.