No Infrastructure to Support Precision Health Yet

Indonesia still lags behind in the development of precision health. It is for this reason that Indonesia has initiated research and the development of precision medicine to be integrated into society.

JAKARTA, KOMPAS – Precision medicine, which takes into account individual genetic factors, environmental adaptation and lifestyle, is deemed the future of prevention, diagnostics and health care. Compared with other countries in the Asia-Pacific region, Indonesia still lags behind in the development of personalized medicine as there is no infrastructure and human resources to support it yet.

Indonesia scored 29 in the 2020 Asia-Pacific Personalized Health Index report, which is below the average score of countries in the Asia-Pacific, at 51. Countries that scored the highest included Singapore (71), followed by Taiwan (67) and Japan (64).

This assessment by The Copenhagen Institute for Futures Studies and Roche measured four criteria, namely policy context, health information, personalized technology capabilities and health services.

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“Indonesia was placed last in the context of health policy and information, performing only slightly better in healthcare services,” said Herawati Supolo Sudoyo, geneticist and chair of the Indonesian Academy of Sciences’ Medical Commission on Monday (16/1/2023). She was one of the panel experts for the assessment.

The three highest-scoring countries in the index – Singapore, Taiwan and Japan – performed the best across all indicators. Meanwhile, Thailand, Malaysia, China and India scored below average but still did better than Indonesia. “Indonesia’s poor position in genomics and precision medicine is because it lags behind in infrastructure and human resources,” she added.

In Indonesia, genomic research was previously pioneered by the Eijkman Institute for Molecular Biology, aimed to map the genetic characteristics of Indonesians. Last year, the Eijkman Institute was merged with the National Research and Innovation Agency (BRIN) causing some its human resources to scatter. “This was a setback for the Eijkman Institute and Indonesian genetics research,” said Herawati, who led the establishment of the Eijkman Institute along with geneticist Sangkot Marzuki.

KOMPAS/RIZA FATHONI

Staff at the Faculty of Medicine, Yarsi University, Cempaka Putih, Central Jakarta examines a patient's genetic sample in the laboratory, Friday (13/1/2023). In precision medicine, it is possible for a person to get more sensitive health screening, precise diagnosis, and effective therapy.

Catching up

Now, Indonesia is preparing and building an ecosystem to develop precision medicine in order to leverage the quality of public health. According to the Health Ministry’s pharmaceuticals and medical devices director general Rizka Andalucia in Jakarta yesterday, the government has started implementing precision health for the community. One way is through the Biomedical and Genome Science Initiative (BGSi).

“The concept of the BGSi is to serve as a catalyst for the implementation of precision medicine in Indonesia. Within the first two years, the BGSi will collect data on 10,000 sequences and biospecimens with integrated data. This data will be accessible to develop health innovations related to precision medicine,” said Rizka.

The development of precision medicine is part of the government’s efforts to provide better healthcare services. Scientific research has shown that each individual has a unique response to different certain therapies, depending on one’s genetic code.

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The BGSi will later support eight vertical hospitals to start genomic-based precision medicine services. The involvement of these hospitals is expected to accelerate the implementation of precision health in the community.

Nine projects will be launched, consisting of Covid-19 handling and whole genome sequencing (WGS), as well as seven priority diseases, such as infectious diseases, metabolic diseases, cancer, genetic disorders, aging and nutrition.

The BGSi’s technical person in charge, Ririn Ramadhany, added that preparations had to be made to implement the BGSi initiative, such as the readiness of health workers, infrastructure and human resources expertise.

There must be good data storage infrastructure. Precision medicine is related to big data.

Herawati said that Indonesia must overcome its lack of development in precision health. In addition to building data reporting systems and improving genomic screening capabilities, clinicians must also recognize the value of patient data. “There must be good data storage infrastructure. Precision medicine is related to big data,” she said.

BRIN Health Research Organization head Indi Dharmayanti also believed the development of precision medicine in Indonesia was held back by limited infrastructure, especially information technology laboratories to complete genetic data. Another obstacle is related to testing accuracy and limited human resources.

Ines Atmosukarto, a molecular biology researcher from Indonesia at the John Curtin School of Medical Research at the Australian National University, who is also an expert at the Health Ministry, stressed that the BGSi concept must be sustainable as its development and utilization may last for more than two decades.

This article was translated by Kesya Adhalia.