Search

Despite an enormous population and growing economy, the nation of Indonesia has some of the world's highest concentrations of neglected tropical diseases (NTDs). These NTDs may thwart future national growth and recent gains. Yet, Indonesia and its Ministry of Health, together with the World Health Organization (WHO), have embarked on an ambitious effort to quickly assemble a health and scientific infrastructure suitable for eliminating its NTDs. The nation of Indonesia is the world's largest island nation (approximately 17,000 islands of which 5,000–6,000 are inhabited) and the fourth most populated nation behind China, India, and the United States (Figure 1) [1]. The nation is tied with the Netherlands as the world's 16th largest economy [1]. According to the World Bank, Indonesia together with South Korea and the BRIC (Brazil, Russia, India, and China) countries will account for more than half of the world's economic growth by 2025 [2]. Figure 1 Map of Indonesia. Despite the future promise of these economic gains, Indonesia is also simultaneously hobbled by a staggering level of extreme poverty. According to the World Bank, of Indonesia's estimated population of 242 million [3], an estimated 46% (approximately 111 million people) live on less than $2 per day [4], while 18% (44 million people) live on less than $1.25 per day [5]. Today, one of the most potent forces that currently traps Indonesia's poorest 111 million people in poverty and could eventually threaten Indonesia's economic potential is a group of NTDs affecting the region. The NTDs are chronic conditions with clinical features similar to many noncommunicable diseases [6]. When they become widespread [6], these diseases have the ability to thwart or stall economies because of their adverse impact on child development, labor, and the health of girls and women [7]. Indeed, Indonesia's “bottom 111” million suffer from an extraordinary level of NTDs, led by widespread helminth infections, such as soil-transmitted helminth (STH) infections and lymphatic filariasis (LF), and neglected bacterial infections, such as yaws and leptospirosis (Table 1) [8]. Moreover, Indonesia is the only country in the WHO's South-East Asia Region with endemic schistosomiasis [8] (the other Asian countries with endemic schistosomiasis are in WHO's Western Pacific region), and the nation is facing a serious and emerging threat from dengue fever [9]. Table 1 The major neglected tropical diseases of Indonesia.