Diseases of poverty are undermining Indonesia’s competitiveness

Harold Mandel's picture

There is a striking increased incidence of many neglected tropical diseases associated with poverty. There are often debates about whether or not the poverty itself, which is associated with increased rates of many diseases, is actually the cause of this problem or the result of deficient minds among people in poverty which leaves them less motivated and capable of competing effectively in society. The facts again and again show that poverty itself is the primary culprit in such instances and that if given a fair chance to rise out of the ashes of poverty most poor people could do just fine competing well in every realm of life.

There are many serious tropical diseases which are seen with increased incidence with poverty, particularly in Indonesia. Indonesia represents an emerging market economy which is beset by neglected tropical diseases (NTDs), reported PLOS One. A careful analysis of the situation in Indonesia can therefore serve as a good model to study the effects of extreme poverty on the spread of infectious diseases.

In spite of a large population and a growing economy, Indonesia nevertheless has some of the world's highest concentrations of neglected tropical diseases (NTDs). These NTDs may undermine future national growth and recent gains in the country. Indonesia and its Ministry of Health, along with the World Health Organization (WHO), have embarked on an ambitious effort to quickly put together a health and scientific infrastructure which is suitable for eliminating its NTDs.

Indonesia is the world's largest island nation which is made up of approximately 17,000 islands of which 5,000–6,000 are inhabited. This country is the fourth most populated nation behind China, India, and the United States. Alongside the Netherlands, Indonesia has the world's 16th largest economy . The World Bank says that Indonesia together with South Korea and the BRIC, which includes Brazil, Russia, India, and China, will account for more than half of the world's economic growth by 2025.

In spite of the future promise of greater economic gains, Indonesia is also now simultaneously struggling with a staggering level of extreme poverty. Out of a population of about 242 million people, according to the World Bank, an estimated 46 percent, or approximately 111 million people, live on less than $2 per day, while 18 percent, or 44 million people, live on less than $1.25 per day. A potent force which currently traps Indonesia's poorest 111 million people in poverty and may eventually threaten Indonesia's economic potential is a group of NTDs which affect the region. These diseases have the ability to undermine or stall economies because of their negative impact on child development, labor, and the health of girls and women.

The "bottom 111" million people in Indonesia suffer from an extraordinarily high level of NTDs, including:

1: Widespread helminth infections, such as soil-transmitted helminth (STH) infections

2: Lymphatic filariasis (LF)

3: Neglected bacterial infections, such as yaws and leptospirosis

4: Endemic schistosomiasis

5: A serious and emerging threat from dengue fever


Clearly, Indonesia’s competitiveness is at risk from neglected diseases of poverty, reports the Sabin Vaccine Institute. Scientists have said the control and elimination of neglected tropical diseases (NTDs) is one of the most cost-effective ways Indonesia can sustain economic growth and lower inequality. Indonesia is positioning itself to defeat NTDs by 2020. NTDs are noted as “one of the most potent forces” which traps Indonesia’s citizens, especially women and children, in a viscous cycle of poverty.

Lorenzo Savioli, MD, director of the Department of Control of NTDs at the World Health Organization (WHO), said, “Today, 70 percent of the poorest are in fast growing economies and middle income countries like Indonesia. Indonesia’s commitment to and investment in controlling and eliminating NTDs could lift millions of Indonesians out of poverty and empower them to lead healthy, productive lives, benefiting the nation as a whole and assuring an equitable distribution of the wealth generated by economic growth.” The leadership of Indonesia in carrying out an ambitious national effort to fight NTDs through its Ministry of Health, in collaboration with WHO and other partners, will also help achieve the WHO NTD roadmap goals by 2020.

Indonesia suffers from the second highest burden of NTDs worldwide. There are an estimated 195 million people, which include 50 million children, who are at risk for soil-transmitted helminths, 125 million people who are at risk for lymphatic filariasis and approximately 25,000 – 50,000 people who are at risk for schistosomiasis. Indonesia has the second largest number of dengue cases worldwide.

Peter Hotez, MD PhD, president of the Sabin Vaccine Institute, has said, “As Southeast Asia’s largest economy, G20 leader, co-chair of the United Nation’s High Level Panel on the post-2015 development agenda, and ASEAN member, Indonesia is clearly positioned to make significant advances against NTDs.” If Indonesia prioritizes NTDs and ensures that treatment and prevention programs reach all vulnerable communities, Indonesia can dramatically improve the lives of its most marginalized citizens.
NTDs can cause a myriad of health problems, including:

1: Anemia

2: Malnutrition

3: Disability

4: Stigma

These health problems prevent kids from attending school, keep adults from working, and increase the consequences of other diseases, which therefore contributes to decreases in human capital and worker productivity.

A view of the staggering problem of pervasive poverty in Indonesia associated with NTDs helps to raise an awareness of how painful and costly poverty really is. In the United States and other countries poverty has been found to be associated with increased rates of diabetes, obesity, asthma, and malnutrition. The filth associated with poverty is also associated with increased rates of infectious diseases in the United States and elsewhere.

In a world growing smaller with a greater appreciation for an interdependence between people in different nations due to the advent of the internet, it becomes clear nobody should be ignoring these catastrophic health conditions associated with poverty. When a crisis hitting mankind is this tragic on such a wide scale it appears to me acts of omission in dealing with these problems in any corner of the world are a serious matter. I suggest the world community rally behind initiatives to wipe out poverty in every corner of the world.

Photo courtesy of renjith krishnan/Freedigitalphotos.net