Financing assessment helps Indonesia plan sustainable health security

The Indonesia Health Security Financing Assessment (HSFA), formally launched in April 2022, has been providing crucial information to the country for developing financing strategies that accelerate and sustain effective health security. It does this by establishing a baseline on the overall size, sources, and flow of financing for health security from the period immediately preceding the COVID-19 pandemic. It also identifies the complex institutional arrangements between key stakeholders in Indonesia’s highly decentralized administrative system, and identifies priority issues in financing for health security. 

Funding

The Indonesia HSFA was supported by the Australian Department of Foreign Affairs and Trade through the Advance Universal Health Coverage Multi-Donor Trust Fund managed by the World Bank. Building upon the results of the Joint External Evaluations (JEE), which were led by the World Health Organization as part of its International Health Regulations implementation in 2017, the HSFA study found a clear gap in information about health security financing across all 19 technical areas of the JEE.

Pressing need for financing strategies

There is a pressing need for Indonesia to assess the financing aspect of all these areas—ranging from prevention and detection of public health threats to rapid and effective response—to forge financing strategies that will complement Indonesia’s National Action Plan on Health Security (NAPHS). 

Recommendations

The Indonesia HSFA makes recommendations that target cross-sectoral foundational issues to improve public financial management of health security activities. These include:

·      Make health security a national development priority that needs to be translated into multi sectoral and inter agency plans and budgets.

·      Develop sensitive and measurable performance indicators to monitor the strategic development plan and the NAPHS whose action plan must clearly indicate the responsible ministries and agencies.

·      Include health security in the process to develop a standardized public budget nomenclature system with codes to track health security spending.

·      Improve health information and accounting systems by taking into consideration Indonesia’s decentralized context.

·      Harmonize budget timelines and procedures between central and local governments to present a comprehensive view of resource allocation and spending for health security activities.

·      Strengthen the NAPHS with disaster-financing mechanisms, learning from the COVID-19 experience.

Addressing these fundamental issues will improve the overall quality of public spending and sustain health security financing in Indonesia, the study says.  Given the importance of investing in pandemic preparedness globally, the Indonesia study, alongside an earlier study on Vietnam, provides important examples on how to measure and monitor a country’s financing of health security.