HEALTH: Vaccine scandal highlights Indonesian health system woes

By Niniek Karmini and Margie Mason (Associated Press) | Updated July 23, 2016 – 5:06am

Jakarta Vaccination

Indonesian health officials inject a baby during a revaccination program for children who were earlier given fake vaccines, at a community health center in Jakarta, Indonesia. Vials of counterfeit vaccines filled with saline solution and antibiotics have been discovered at 37 hospitals and clinics in nine cities, according to the Food and Drug Agency. So far, 23 people have been arrested, including three doctors. The number of affected children is still being investigated. AP/Achmad Ibrahim

JAKARTA, Indonesia —

The avarice of humans has never known any bounds and, with each passing day, this contention has been proved manifold a million times over; scams are scams but some of them put even Satan to shame with the sheer audacity and impunity with which they are perpetrated.

Here comes another one, in Indonesia this time, that has left almost the whole populace with a deep-seated simmering anger and a silent rage over the sheer helplessness of a parent at being unable to prevent the sickness or even death of their child, that too unknowingly. The saddest part of this episode is that the perpetrators are deliberately playing with the lives of innocent humans, young or old.

The very medicines that are supposed to cure you are turning out to be your killers; how can a person believe anybody or anything in such a scenario?

This helplessness and anger of the common Indonesian has started to boil over and there have been incidences of assault of doctors and the resultant action on all those whose involvement in this sordid scam is suspected or confirmed.

The scandal involves the large-scale distribution of fake vaccines in the Indonesian Health System and not just distribution but administration of these spurious vaccines to the tiny tots who are very sensitive and delicate particularly when they are unwell.

The emergence of this scam is a clear indicator of the fact that everything is not right in the health system of the country and that unscrupulous elements have been able to make inroads into the system to take advantage and make a fast buck, even at the cost of innocent lives.

In the resultant investigations that have been conducted following the unearthing of the scam last month, it has been discovered that vials which bear the vaccine’s markings have been found to contain only antibiotics and a saline solution.

It was found to be true for more than 37 hospitals where the samples were picked up for teasing as per sampling standards in vogue as per the norms of the Food and Drugs Agency.

This has resulted in the arrest of 23 people including 3 doctors; the task of estimating the number of affected is indeed massive since the population of Indonesia is in excess of 250 million; a true figure may not emerge but a rough estimate is only possible. Meanwhile, revaccination of all the children in the re

Joko Widodo, the President of the Indonesia was concerned when this news was broken to him,

Indonesia President Joko “Jokowi” Widodo this week visited a clinic where nearly 170 children were to be revaccinated. He asked for patience while police continue to investigate an “extraordinary crime” of bogus vaccines allegedly going back as far as 2003.

“We are in crisis right now,” said Dr. Aman Bhakti Pulungan, head of Indonesia’s Pediatrician Association. “This is a medical emergency, and we have to overcome this.”
He said he is not aware of any children dying as a result of not being protected against diseases they were believed to have been vaccinated against, but added it’s possible some kids could have gotten sick without being detected. The fake vaccines involved a number of shots routinely given to children, including for measles, whooping cough, hepatitis and diphtheria.

The counterfeits were falsely labeled as imported brands, Pulungan said. He believes the number of children affected is likely small, given that only 1 percent of vaccines administered nationwide are imported. The government began revaccinating children this week free of charge at affected hospitals and clinics, including 14 in the capital Jakarta and its outskirts.

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Local television footage this week showed a mob of angry parents at Harapan Bunda Hospital in eastern Jakarta arguing with a doctor and then punching him and spitting on him before security officers broke up the brawl. Other parents took their rage to the government, complaining to members of parliament and demanding help.

Jane Soepardi, the director of Surveillance, Health Quarantine and Epidemiology at the Health Ministry said Friday the government estimates about 5,000 children from 4.8 million targeted this year for immunization, have gotten fake vaccines.

“Fake vaccines arose because there was a scarcity of vaccine a few years ago that led hospitals and clinics to look for imported vaccines,” she said. “Also because the middle class demanded imported vaccines rather than locally made.”

She said the fakes did not contain harmful substances but it’s possible the unsafe process of producing them could cause infections in children they were administered to.

Health Minister Nila Moeloek has called for calm and warned parents not to panic, but distrust of the health system runs deep in a country rife with corruption, overcrowded hospitals and a lack of qualified doctors. For those who can afford it, Singapore or Malaysia are often the first choice for treatment.

Danang Susilo, the father of 14-month old Chelea, said he is worried about his daughter’s health even though doctors from Karya Medika Hospital at Bekasi on the outskirts of Jakarta assured him the fake vaccine she received was harmless.

“I was shocked and very disappointed when the hospital management asked me, along with about 300 other parents to bring our children for revaccination, because the vaccine that is injected into our children turned out to be fake,” he said. “How could this happen?”

“We need a medical check-up, not only an explanation,” he said. “We need concrete compensation.”

In 2013, the Food and Drug Agency received a report from British pharmaceutical company GlaxoSmithKline about the circulation of counterfeit vaccines bearing its name. The perpetrator was caught and fined less than $100. Additional problems were discovered in 2014 and 2015. This year, PT Sanofi-Aventis Indonesia, a subsidiary of French pharmaceutical company Sanofi, notified the National Police about fake vaccines using its product labels, according to the agency.

Dr. Kartono Mohammad, former head of the Indonesia Medical Association, said regulations are in place to ensure that safe vaccines are administered, but enforcement and monitoring are weak. He said that the vaccine scandal is a symptom of a much larger problem, and that the country’s entire health system should be overhauled.

“The attitude of the Indonesian people, especially the middle class, is that they look at the building and the facility and they say: This is the best hospital,” he said. “But nobody knows if it really is a good hospital or not because there is no quality control, no quality assurance done by the government.”