The Indonesian Ministry of Health (MoH), World Health Organization (WHO) and key partners are gearing up for a final, concerted push to eliminate lymphatic filariasis (LF), leprosy and yaws, based on the recommendations of an in-country review conducted on 19–26 August 2024. The review was the first in the WHO South-East Asia Region to simultaneously address the three skin-related neglected tropical diseases (NTDs), which primarily affect communities in remote and hard-to-reach areas.
By 2023, a total of 168 LF-endemic districts in Indonesia had completed and stopped mass drug administration (MDA), having achieved adequate coverage for five consecutive years. This is the period required to halt transmission. In 2023 Indonesia reported a cumulative 7955 LF cases, with 68 endemic districts continuing to conduct MDA activities. Of these, 45 await verification to stop MDA.
However, in the same year, Indonesia reported 14 376 new cases of leprosy, the third highest globally. Of these, 8.2% are children and almost 6% involve Grade 2 disabilities. This indicates both active transmission and delayed diagnosis. In 2023 Indonesia reported just 68 cases of yaws, with 257 out of 514 districts now certified yaws-free.
“Indonesia has in recent years made strong progress against skin-related NTDs, but continues to face an array of challenges, especially in remote and hard-to-reach areas,” said dr. Yudhi Pramono, MARS, Ag. Director General Disease Prevention and Control, MoH, Government of Indonesia. “I am confident that this review will enhance cross-sectoral collaboration, and also help leverage technology in our onward journey towards the 2030 NTD targets.”
The review team visits a patient with lymphedema
and demonstrates basic principle of morbidity management and disability
prevention (WHO/Agrin Zauyani Putri)
The eight-day in-country review was led by the WHO Country Office, WHO Regional Office for South-East Asia and Indonesia's National NTD Programme. It brought together national and international experts, and included field visits to three endemic districts – Sorong Selatan in Southwest Papua Province, Mimika in Central Papua Province, and Belitung in Bangka Belitung Province.
There, reviewers assessed epidemiology and surveillance, health system capacity, treatment and case management practices, vector control strategies, and behaviour change communication. They also engaged veterinary public health experts on zoonotic LF transmission, to better understand and mitigate animal-to-human transmission risks.
The review team in Mimika District, Central Papua Province, assessing the availability and supply chain management of multi-drug therapy medicines (WHO/Agrin Zauyani Putri).
“Today, Indonesia has an outstanding opportunity to build on its momentum, overcome present and emerging challenges, and eliminate these and other NTDs,” said Dr Momoe Takeuchi, Deputy WHO Representative to Indonesia. “Through a more integrated approach – aligned with Indonesia’s Health Transformation agenda – together we can ensure that no person or community is left behind.”
Among key preliminary recommendations, reviewers highlighted the importance of incorporating NTDs into the National Medium-Term Development Plan (RPJMN) and Health Master Plan (RIBK) 2025–2029. They also emphasized the need to improve financial and human resources, create a supportive policy environment, integrate NTD monitoring and reporting into the national health system, and enhance training and supervision for existing human resources.
Additional recommendations include increasing community engagement, securing more funding for active case detection and contact tracing, and ensuring consistent resources for MDA, training and laboratory-led surveillance initiatives.
Once finalized and acted on, these and other recommendations will help Indonesia to eliminate LF, leprosy and yaws, achieve the 2030 NTD targets, and create a future where every community lives free from these debilitating and avoidable diseases.
The in-country review was supported by Sanofi, Sasakawa Health Foundation, and the US Government through USAID.
Written by Achmad Naufal Azhari, Technical Officer, WHO SEARO; Herdiana Hasan Basri, National Professional Officer (malaria & vector-borne diseases), WHO Indonesia; and Agrin Zauyani Putri, National Consultant for NTDs, WHO Indonesia