The BBC World Service this week ran a 30-minute in-depth examination of Indonesia’s alarmingly vague plans for a universal healthcare service. Following the BBC’s fashion for human interest, the programme is heavy on disconnected individual stories and light on heavy analysis. Indonesia’s health minister, Dr Nafsiah Mboi, must have been relieved not to be questioned more closely on her assertion that all preparations for the new national service would be ready by 2014. Still, the programme is worth a listen.
Indonesia’s barefoot doctor programme — using partly-trained healthcare workers — probably deserves more credit than the BBC gives it. Certainly it has had much more of an impact on health outcomes than the programme suggests. The country’s enormous successes in family planning don’t get a mention either — strange because Dr Mboi’s views on contraception are strident and controversial.
Oddly, the BBC also entirely fails to engage with the biggest issue of all: Indonesia’s abysmally low levels of public spending on health. According to the World Bank, health spending as a proportion of GDP has fallen from 1.1% of GDP in 2009 to just 0.9% in 2011. This is a fraction of the WHO-recommended level and far less than the 7 or 8 percent in industrialised countries or the 6 percent in Rwanda, which is considered to have been fairly successful in introducing an insurance-based universal healthcare system. It’s even below the widely-criticised 1.2% spent by India. This could be a particular problem because Dr Mboi is currently chair of the Global Fund and leading the call for sustained donor spending on AIDS, malaria and TB.