COVID-19 VACCINE STRATEGIES IN INDONESIA AND THEIR RELATIONSHIP WITH NATIONAL RESILIENCE

 

Nurhasan Agung Prabowo ^1,2,3 , Hartono ^1,2,3,  Adjie Suwandono ^1,2

 

¹ Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia

² Universitas Sebelas Maret Hospital, Sukoharjo, Indonesia

³ Doctor Medical Sciences, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia

 

1. INTRODUCTION

The virus that is causing Coronavirus Disease 2019, or COVID-19, is approaching the Indonesian state. COVID-19 has become a pandemic. Indonesia is currently said to be in the middle of a COVID-19 pandemic. Something that no one expected. COVID-19, which has become a pandemic, has in fact succeeded in having a negative impact in Indonesia. Various sectors, such as health, the economy, and others, have become victims of the COVID-19 pandemic. In the health sector, many Indonesians have been affected by the disease. Then many people died due to COVID-19. According to information from the Communications Team of the Corona Virus Disease (Covid-19) and the National Economic Recovery Committee, as of December 31, 2020, there were 743,198 positive cases of Covid-19. The number of patients recovered from COVID as of December 31, 2020, was 611,097. The number of patients who died due to Covid-19 was 22,138 cases Diniyanto (n.d.)

COVID-19 (Corona Virus Disease 2019) has been in Indonesia for two years. Various efforts have been made by the government and the people of Indonesia to tackle this disease. Data on Sunday, January 23, 2022, stated that there were 4,283,453 COVID-19 cases, with new topics on January 23, 2022, being 3,205 new COVID-19 cases. The data shows that 180,714,550 have been vaccinated for the first dose, and 123,782,386 have been vaccinated for the second dose (Kementerian Kesehatan, 2022). In Central Java, there were 625,812 confirmed COVID-19 patients as of January 23, 2022, and 20 new COVID-19 cases Kementerian Kesehatan. (2022). The Central Java ranks three nationally, and the number of confirmed COVID-19 patients is 16.6% (Tanggap COVID-19 Provinsi Jawa Tengah, 2022). Meanwhile, the coverage in Central Java as of January 23, 2022, is 86.27% for dose 1 (sequence number 9 nationally) and 65.17% for dose 2 (sequence number 6 nationally) Kementerian Kesehatan. (2022). Vaccines are an essential step in the fight against COVID-19. In Indonesia, ten vaccines are circulating: inactivated viruses, RNA-based, viral-vector, and protein sub-unit. There are ten brands in circulation: Sinovac, AstraZeneca, Sinopharm, Moderna, Pfizer, Zifivax, Novavax, Sputnik-V, Convidencia, and Janssen Barratut Taqiyyah Rafie. (2022). The COVID-19 vaccine showed excellent efficacy in clinical trials and effectiveness in real-world data, but some people were still infected with SARS-CoV-2 after vaccination Antonelli et al. (2022).

The Preamble to the 1945 Constitution of the Republic of Indonesia says that the National Goal is to create a "State Government" that protects the whole Indonesian nation and the whole country of Indonesia, improves public welfare, educates the people of Indonesia, and helps create a world order that is based on independence, lasting peace, and social justice. To achieve national goals, there needs to be national resilience, which is a dynamic state of integrated national life that will one day be reached and is able to face and overcome all challenges, threats, obstacles, and disturbances. As a global disaster, the COVID-19 pandemic has weakened national resilience and is a bother, a threat to the achievement of national goals, and a problem that everyone must work together to solve.  The impact of the COVID-19 pandemic on national resilience is quite significant. Lemahnas has looked at the data and found that the COVID-19 pandemic has led to a drop in national resilience. This is measured by the calculation of the National Resilience Index (IKN) value made by Lemhanas. Before the pandemic, the IKN score was 2.82, which was included in the fairly tough category. After the pandemic, the score dropped to 2.70. This value was included in the category of quite tough before becoming less resilient Umar Daihani (2020). Also, when looked at from the perspective of each group, it is clear that the COVID-19 pandemic has a direct effect on demographic and economic factors. The demographic gatra index value before COVID in December 2019 was 3.27 and after the pandemic (June 2020), it fell to 2.63. In terms of demographics, morbidity, mortality, spatial mobility, and job opportunities have changed, and their index values have gone down. From an economic point of view, the index value in June 2020, after the pandemic, was 2.65, which was less than it was in December 2019 (2.95).  Food, housing, poverty, job opportunities, fairness, national competitiveness, and market efficiency are all economic factors whose index values go down. The COVID-19 pandemic has effects on politics, ideology, sociocultural, geography, and SKA (natural resources), as well as on the population and the economy. This is because the eight pillars of national resilience work together and are complete as a whole. That is, the dynamics in one or part of the gatra will have a dynamic effect on the other gatra. So, in terms of national resilience, how global disasters like the COVID-19 pandemic are handled is at least related to geostrategic issues and national resilience by looking at how disaster issues and problems relate to the natural triad and how the five work together Pantjoro (n.d.).

 

2. METHODS

This article uses a qualitative descriptive approach. Descriptions are used to give a full picture of the situation the article is talking about.  In international relations, qualitative methods usually link one or more of a country's policies to its decision-making processes, which can be found at the micro-historical level Klotz, (2008). In this article, the description of the pandemic's background has led the Indonesian government to speed up its policy on vaccinations in 2020. At the same time, they are placing the vaccine sector as one of the defense concerns in Indonesia. The data collection carried out in the following article is to use the literature search method. Literature The degree obtained has distinct characteristics that can be used as a reference in articles Roselle (2016). The literature used in this article includes official government sources in the form of documents, statements, and releases that the public can access. This article is backed up by information from other sources, like the news, newspapers, and the government, if that information fits with what is being said in this article.

 

3. RESULTS

Astagrata is divided into two, namely Tri Gatra and Panca Gatra Wiswayana (n.d.). Tri Gatra has three identities: geography, natural wealth, and the population's ability. Then, this article will look at what the Government of Indonesia thought about the COVID-19 vaccination in terms of identifying where people are from.  Then on natural wealth, it will be seen how the resources support COVID-19. Finally, based on the population's ability, it will be identified how human resources support COVID-19 vaccination. Panca Gatra contains five things (ideology, politics, economy, socio-culture, and defense-security). Regarding ideology, this article will look at how Indonesian ideology and politics guide concepts, strategies, and operations in COVID-19 vaccination. Also, from an economic point of view, it is a part of the vaccination program. Then, for socio-cultural matters, we will see how the local conditions are with the existing cultural approach. Lastly, in defense and security, this section is strategic, considering that the vaccination policy of the Government of Indonesia is categorized as part of the defense.

Geographical conditions and COVID-19 vaccination are closely related. The COVID-19 pandemic has no geographical boundaries Vaccine distribution in Indonesia is geographically constrained (areas called remote areas, then border areas, and islands). Limited distribution of vaccinators Distribution of health facilities for vaccines is limited. Cold Chain governance is little.

Natural wealth is related to imported vaccines with low domestic content that do not take advantage of Indonesia's natural wealth. Biofarma vaccines with 79% domestic content will only be in phase 3 clinical trials in June 2022. human resources show that vaccinators are limited in big cities and rarely in rural areas, and that vaccine experts and researchers in Indonesia are limited

Indonesian nationalism says that vaccine research shows the country's independence, even though the country still uses vaccines made by other countries. Participating in the vaccination program leads to the practice of Pancasila, especially the Precepts 3. From a political point of view, the implementation of vaccination and the handling of COVID-19 politically caused Indonesia's status of being banned from flying to be lifted. From an economic and financial point of view, vaccination activities lead to people getting used to the new normal. Financial activities resume, people's incomes go up, and the government pays for vaccines through taxes and other means. From a cultural perspective, it shows that there are anti-vaccines that refuse vaccines in some groups of people. The Covid19 vaccine has received a lot of rejection from the public for specific reasons, including regarding the safety and halalness of the vaccine. The growing suspicion that the vaccine is not halal, especially the Sinovac type, is because of the Vero cell content from the kidney of the African Green Ape, which is considered unsafe and haram for humans. The next obstacle is the assumption that the COVID-19 vaccine that will be given in bulk is a vaccination program that is only intended for clinical trials. Not to mention that there are groups in our society who still have a fatalistic mindset, so not only do they refuse to be vaccinated, but many of them don’t also even believe that COVID-19 is real. From the point of national security defense, it shows that COVID-19 is a threat to the state, so the national security defense program is vaccination.

 

4. DISCUSSION

Nationalism teaches us to create and maintain the state. Developing an idea of ​​a nation's name for a group of citizens who have the same goals and future to serve the interests of the state, nationalism can also be interpreted as teaching to love the nation and their own country. Coronavirus, or often called Covid-19, is a species of virus that causes diseases that attack living things, namely humans and animals. This coronavirus infects humans and causes respiratory infections ranging from colds to severe conditions; diseases include Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). Corona has been found in different places during research, but it won't be known until March 2020 if it can be spread through poop, though it is thought that it is enough. This new type of COVID-19 was discovered by humans in an extraordinary event in Wuhan, China, in December 2019 and was later named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV2) and caused Coronavirus Disease-2019 (COVID-19). COVID-19, which has a diameter of 60-140 nm, is genetically different from the SARS-CoV and MERS-CoV viruses. National Resilience is a method used to direct all national resources that contain persistence where persistence can develop national strength to welcome and overcome all obstacles, risks, and provocations, both internal and external, directly and indirectly, that can change morality, identity, and survival of the nation and state, and hard work to track the goals of the national struggle in Indonesia Bagus Khotibul et al. (2020).

Nationalism is a sense of pride in one's country and state. It does this by promoting an attitude that puts socialism first. Love for the homeland and satisfaction can also be seen as a nation-building effort which means changing community compliance from narrow community adherence to ethnicity, religion, race, and so on, to broader compliance, namely nationality. According to Soekarno, the attitude of Indonesian nationalism points to nationalism or chauvinism and is not a lie of western nationalism. Currently, the Indonesian nation is in a condition exposed to the COVID-19 outbreak in which every Indonesian citizen who is an individual and social person must realize that every decision taken is not only related to himself but also has an interaction relationship in social life and also the surrounding environment. Every citizen can show an attitude of nationalism, both physically and non-physically. As citizens, we can show our patriotism during the pandemic by keeping our distance from each other or separating ourselves from other people in order to stop the spread of COVID-19. COVID-19 should be controlled by complying with the Large-Scale Social Restrictions rules issued by the government to spray disinfectant liquids and impose curfews on large-scale activities that may gather large numbers of people. So, growing awareness of the importance of feelings and attitudes of nationalism amid the COVID-19 pandemic, or what we often call the coronavirus, is essential. The coronavirus can quickly spread to patients through direct contact. The virus is transmitted when an infected person coughs, sneezes, or talks. This virus is transferred rapidly to people who have low immunity. The COVID-19 outbreak that spreads and becomes a global epidemic has an impact on the stability of the country's national resilience. National resilience is the ability of a country to deal with threats by relying on everyone to do their part and work together. Unity and the unity of the government are matters to clarify the meaning contained in the diversity of Indonesia. Indonesia is a country that has a lot of wealth, such as a wealth of culture, ethnicity, and religion. With various kinds of diversity, Indonesia gave birth to unity, namely nationalism and patriotism. One of the characteristics of national resilience is the nature of prudence. Prudence means that a government in a nation must be more self-aware of the identity of a pony. Information on the spread of COVID-19, or the coronavirus, and the impact of its space in the media is very tense, especially online media Bagus Khotibul et al. (2020).

Mechanisms and Strategies for Health Financing during the COVID-19 Pandemic in Indonesia, referring to Article 28 H, Paragraph 1 of the 1945 Constitution of the Republic of Indonesia, which says that everyone has the right to equal health services, which leads to a policy called "health financing." Article 34 of the Republic of Indonesia's Constitution from 1945 also says that the state is responsible for health services for the whole community and social security for people who can't pay for them. In Indonesia, most of the money for health care comes from the APBN, APBD, out-of-pocket payments, private funds, grants, and company donations. In obtaining one of the sources mentioned, a minimum of 5% of the APBN is taken by the central government, while the regional government takes the APBD as much as 10% Suwandono and Paulina (n.d.)

In 2014, the government of Indonesia set up the National Health Insurance (JKN) program to fix the uneven way health services were given out. Both Law No. 24 of 2011 about the Social Security Administering Body (BPJS) and Law No. 40 of 2004 About the National Social Security System (SJSN) were used to create JKN. People in the lower middle class, in particular, can expect that JKN will make it easier for them to get health services when they need them. To get protection from the JKN program, people must include themselves by registering for BPJS first. When a community member has that card, they can use it to get health services based on what they need.  Until 2019, the number of people who have registered themselves in the JKN program has reached 224 million. This figure continues to increase until now, which has stepped on the 241 million National Resilience, especially national resilience, in the face of a global epidemic as this study has shown, not all countries have the same advantages or strategic situations, such as the factors that help people resist the virus.  For instance, when subtropical countries get four seasons or when BCG training programs start up again in developed countries, this changes the way countries and liberal democratic societies act. The National Resilience Strategy must be revised, but each country's typology is different. One national security strategy can't be used by all countries with other geographical areas, socio-political behaviour, and health, economic, defense, and security policies. Plans need to start over from the most basic level of resilience, which is the resilience of individuals and families. Garmezy (1984), one of the first people to study resilience, worked in this area for decades. The National Resilience Strategy must start here, then extend to Community Resilience (village to Regency/City). In Indonesia, resilience practices have started in villages to respond to the basis of national resilience should be considered in reconstructing the National Resilience Strategy against all shocks, threats, and risks, including the threat of a deadly global outbreak. When rebuilding the National Resilience Strategy to deal with all shocks, threats, and risks, including the risk of a deadly global outbreak, it is important to think about what makes a country strong. The definition of community can be different but the purpose of an individual or family is no different. Finding solid communities is tricky as well as communities, traditional and cultural communities in developing and developing countries. which is usually a primordial tradition in a constructive sense. To solve the paradox of national resilience in the post-epidemic era, each country's national resilience will be different and have its own traits. Something should be considered when fortifying. Economic resilience between nations is one of the typical actions to enhance the national resilience of a country, for example, collaboration in the discovery of vaccines between pharmaceutical companies.

 

CONFLICT OF INTERESTS

None. 

 

ACKNOWLEDGMENTS

None.

 

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