Have you ever imagined our bodies possessing a natural source of medicine that works all the time? According to Dr. Sandy Qlintang, M.Biomed, President Director of PT Bifarma Adiluhung, that's the miracle of stem cells. 

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Their existence may still sound unfamiliar to some, but their benefits are extraordinary. Stem cells are more than just a medical term; they represent a new hope for the world of healthcare, including in Indonesia.

From the beginning of our lives, stem cells have been present in our bodies, developing in the mother's womb. These cells are the starting point for the formation of more than 200 types of cells that make up the human body's organs.

After birth, stem cells remain, infiltrating the walls of blood vessels, and continuously working to repair any damage. However, with age and an unhealthy lifestyle, stem cells' natural ability to repair the body diminishes. This has led to the emergence of innovative, modern stem cell-based therapies.

In Indonesia, stem cell therapy has become a new star in the medical world, offering solutions for diseases that are difficult to treat with conventional methods.

While conventional medicine relies on pharmaceutical drugs, biological drugs, or medical devices, stem cell therapy has emerged as the fourth pillar, revolutionizing the healthcare sector.

"Stem cells are a form of regenerative therapy. With a focus on regenerative medicine, this therapy enables the recovery of the body damaged by degenerative diseases such as diabetes, stroke, and even autoimmune disorders," explained Dr. Sandy Qlintang exclusively during a visit to the VOI Media office in Tanah Abang, Jakarta.

Although promising, the journey of stem cell development in Indonesia is not without challenges. PT Bifarma Adiluhung, a subsidiary of Kalbe Farma, is a pioneer in this field.

Starting in 2006, they developed stem cell therapy through intensive research. It took seven years until finally, in 2013, the first stem cell factory certified by the Food and Drug Monitoring Agency (BPOM) was established. Here's the full explanation. To learn more, check out the interview excerpt below!

What exactly are stem cells, and what are their benefits and uses?

Stem cells, or in Indonesian, stem cells, are a miracle of the body that God has given us. Since we are still in the womb, stem cells develop and transform into more than 200 types of cells that form our organs.

After birth, stem cells remain in the body, primarily attached to the walls of blood vessels. Their function is extraordinary, namely repairing any damage and inflammation that occurs in our body.

These stem cells are like a "natural pharmacy" in the body. However, with age or an unhealthy lifestyle, our stem cells weaken. With modern technology, stem cells can be harvested, developed, and used for currently known medical therapies.

What differentiates stem cell therapy from other conventional treatment methods?

Conventional medicine has three main pillars: pharmaceutical drugs, biological drugs such as insulin, and medical devices such as heart stents or metal implants.

However, these three pillars are not enough to address complex degenerative diseases. This gave rise to the fourth pillar in the world of health: cell therapy, including stem cells.

This therapy offers regenerative medicine, capable of repairing body tissue damaged by diseases such as diabetes, stroke, and Parkinson's. With stem cell therapy, the body gains the ability to "reverse," or return to normal.

However, this therapy does not completely replace bodily functions. Instead, stem cell therapy supports the body by addressing the effects of aging or poor lifestyle habits that accelerate body damage. A healthy lifestyle remains key to maintaining optimal function of our natural stem cells.

How does stem cell therapy work in treating diseases such as diabetes, cancer, and autoimmune disorders?

Stem cells work by repairing tissue damage, reducing inflammation, and balancing the immune system. In a healthy body, natural stem cells continuously regenerate to prevent disease. However, when poor lifestyle habits accelerate damage, stem cell therapy becomes a solution.

The best stem cells are usually taken from the umbilical cords of newborns, because they are young and of high quality. After being developed in a factory, these stem cells are administered to patients through injection. The stem cells then function like natural cells, providing repair, anti-inflammatory effects, and balancing the patient's immune system.

Well, it works the same way as when the stem cells were created by God. Because the stem cells are all good, they will regenerate, act as anti-inflammatories, and balance the immune system, resulting in repair.

How safe and effective is stem cell therapy, especially in terms of the risk of short- and long-term side effects?

Yes, stem cells are considered safe, but it depends on the source. As mentioned earlier, the source can come from a person who has already been born, from their placenta, or from an elderly person, from their bone marrow or fat. Basically, anything with blood vessels can be used for stem cell therapy.

There are also stem cells taken during human development in the mother's womb. These are called embryonic stem cells. Embryonic stem cells, so the embryo is the embryo that will become a human, are taken by humans and made into stem cells. These stem cells are dangerous.

It's not permissible religiously, right? Because it's an abortion, right? The embryo of life is taken, killed. So, religiously, it's not permissible. But it's also dangerous from a health perspective. Why? It can cause cancer or a malignancy called teratoma.

So, be careful with stem cells derived from embryos, and secondly, stem cells called pluripotent. They are also dangerous. Many foreign countries, including Singapore and Japan, offer pluripotent stem cells.

The use of this type of stem cell, especially those derived from embryos, carries the risk of serious health problems, such as the formation of tumors called teratomas. Teratomas are tumors that can contain various types of body tissue, such as hair, teeth, or even blood clots, which should not be present in a single tumor.

Because of these potential risks, pluripotent stem cells derived from embryos or other uncontrolled sources must be used with caution and adhere to strict regulations in medical practice and research.

What lifestyle factors influence the effectiveness of stem cell therapy?

Although stem cells can repair our body's cells, if they are not combined with a healthy lifestyle, their effectiveness will be reduced. For example, if we don't maintain a good diet, exercise, and sleep, the repaired body cells can become damaged again, requiring stem cell therapy to be repeated.

Therefore, maintaining a healthy lifestyle is crucial for stem cell therapy to work optimally.

PT Bifarma Adiluhung has been innovating in developing stem cell therapy services. Since when?

PT Bifarma Adiluhung, a subsidiary of Kalbe Farma, began developing stem cell therapy in 2006 through the STEM Cell and Cancer Institute. For seven years, in-depth research was conducted in the laboratory to understand stem cell development and applications.

In 2013, they established the first stem cell factory in Indonesia certified by the Indonesian Food and Drug Authority (BPOM). This certification is crucial to ensure the safety and quality of stem cells before use on humans. The factory continues to operate today, supporting the development of stem cell therapy in Indonesia.

What are the main challenges in developing and implementing stem cell therapy in Indonesia?

There are several major challenges in developing this therapy. First, the raw materials for stem cells must be imported from abroad, such as the United States and Europe, making production costs very high. The price of therapy can reach Rp 300 million to Rp 400 million.

Second, the factory infrastructure must be kept sterile 24/7, with support systems such as generators that must be activated within seconds in the event of a power outage.

Third, human resource training is also a challenge. However, Indonesia has a large pool of experts capable of understanding this technology through intensive domestic training.

What standards or regulations must be met to ensure the safety and efficacy of this therapy?

To ensure the safety and efficacy of stem cell therapy, there are two main regulators in Indonesia: the Ministry of Health and the Food and Drug Authority (BPOM). The Ministry of Health issues regulations for stem cell products still under research and those that have become standard services, such as therapies for orthopedic and traumatology cases (e.g., osteoarthritis).

The BPOM is responsible for ensuring that stem cell products are safe, sterile, and produced to high standards. Certification from the Food and Drug Authority (BPOM) and freedom from animal products (including pork) are essential to ensure quality.

How does PT Bifarma Adiluhung ensure high-quality stem cell therapy?

PT Bifarma Adiluhung ensures high quality by becoming a BPOM-certified pharmaceutical company. This certification must be renewed every five years, and PT Bifarma has been doing so since 2013, demonstrating its commitment to high and consistent quality and standards for stem cell production.

This certification demonstrates its commitment to the safety and quality of the therapy provided to patients. Furthermore, BPOM certification must be renewed every five years.

So, we have had approximately three renewals. Since 2013, 15 years ago, we have been improving or renewing our legal entity permits and continuing to obtain this certification. So, it can be said that this is a high standard for stem cell production.

How does PT Bifarma Adiluhung contribute to making this therapy more affordable for the wider community?

During the COVID-19 pandemic, stem cell therapy was used to help COVID-19 patients. For example, for 40 patients, the total cost was approximately IDR 12 billion. However, the research grant received only around IDR 300 million, with the remainder supported by Kalbe.

This demonstrates how stem cell therapy plays a role in supporting efforts to treat dangerous diseases like COVID-19, despite the enormous costs involved.

There are several others, such as those currently in development, which we are also pursuing through distribution permits. This is interesting: this distribution permit number is from the Food and Drug Authority (BPOM). This distribution permit number is currently being developed specifically for osteoarthritis. If this distribution permit is obtained, for osteoarthritis, it could be issued in 2027 for wider use.

Are there any new innovations in the stem cell field being developed by your company?

Currently, there are several important initiatives in stem cell research in Indonesia. One example is the development of stem cell therapy for osteoarthritis (knee joint disorders), which is expected to receive marketing authorization from the Food and Drug Authority (BPOM) in 2027.

Furthermore, research is also underway to use Exosome stem cells in the treatment of chronic kidney failure, a collaboration between the LPDP (Indonesian Food and Drug Authority) and the Ministry of Finance.

This research is already targeted at patients from all walks of life. Hopefully, it will receive marketing authorization and be used for all conditions.

How do you see the future of stem cell therapy in Indonesia in the next 5-10 years?

The future of stem cell therapy in Indonesia is very promising. With a population of over 280 million people and a growing number of elderly people, Indonesia is a potential market for stem cell therapy.

However, the main challenge is avoiding the use of stem cells of unsecured quality, which are often sourced from abroad. Stem cell therapy in Indonesia can help treat degenerative diseases, which are increasing among young people due to unhealthy lifestyles.

Furthermore, with the increasing elderly population, stem cell therapy can reduce the burden on the state by helping patients return to productivity.

The main challenge is ensuring the safety and quality of stem cell therapy received by the public. Because many stem cell therapies originating from abroad are not guaranteed in terms of quality, Indonesians must be careful when choosing the right therapy.

Furthermore, degenerative diseases previously only found in older people are now starting to appear at younger ages, further adding to the burden on the state. Therefore, maintaining a healthy lifestyle is crucial as a preventative measure.

Inspired by a Fellow Professional, Dr. Sandy Qlintang M.Biomed.'s Story of Studying Stem Cells

Choosing to pursue stem cell research for Dr. Sandy Qlintang, M.Biomed., is a way to continue the noble ideals of his colleagues. As President Director of PT Bifarma Adiluhung, he wants to continue the extraordinary work of Dr. Bun, Dr. Bunnyawin Setiawan PSD.

"I was inspired to pursue stem cell research by Dr. Bun. He was one of the founders of Kalbe Farma. In 2006, he had a truly extraordinary and noble goal: to build a stem cell factory or production facility," recalled Dr. Sandy.

Dr. Sandy explained that at the time (2006), no one knew what stem cells were, including himself. However, with great perseverance, Dr. Bun established a development and research institute at Kalbe called the Stem Cell and Cancer Institute on December 1, 2006.

"At that time, we knew that stem cells were still unknown to many people. What were stamp cells? Then, he called on the diaspora. Indonesians living abroad, including those from Japan, Japanese graduates, and American graduates, he invited them to join him in developing stem cells because he knew they had immense benefits for the body. He then invited them to join the stem cell institute he founded," he continued.

When he began developing stem cells, Dr. Sandy Qlintang admitted that he and Dr. Bun both learned from each other. This included seeking publications, studying international journals, traveling abroad, and much more.

"We also studied in Singapore. So, after that, we started. And it turned out stem cells made it that way. Then we conducted research, a lot of research, and at that time, Stem Cell and Cancer Insurance became a cost center, not a profit center. He spent tens of billions of rupiah through Kalbe on stem cell development," he said.

So, Dr. Sandy's interest in the stem cell field began, inspired by Dr. Bun's persistent, consistent, and visionary spirit.

"That's what led us to understand stem cells today. Without him, stem cells might not have developed or even existed in Indonesia today," he said.

After delving into the stem cell field, Dr. Sandy shared his experience developing stem cells in Indonesia and the challenges it faced, particularly in terms of human resources.

"Personally, maintaining good, high-quality stem cell production presents many challenges. The biggest challenge is human resources. Human resources are sometimes undisciplined. Continuous training is necessary to maintain competency. Our procedures are stamped with patient safety standards, so they must be carried out carefully. They adhere to the standards issued by the Food and Drug Authority (BPOM) through good manufacturing practices, as they are certified," he explained.

Then, another challenge arose during COVID-19. When Dr. Sandy and his team needed raw materials, they had to be imported from America and Europe.

"During the lockdown, we couldn't make stem cells because the raw materials came from abroad. At that time, COVID patients needed stem cells. Yes, that was the challenge," he explained.

Vision for Stem Cell Therapy

After delving into the field of stem cells, Dr. Sandy envisioned changing the medical landscape through stem cell therapy, specifically through Samsanal therapy.

"Yes, so we at PT. Adiluhung want Indonesia to become a leader in its own country in the field of cell therapy. Cell therapy isn't just stem cells; there's also another cell therapy called immune cell therapy," he said.

He explained that this therapy is excellent for cancer patients. There's also immune cell therapy. Dr. Sandy hopes Indonesia can become a country that can thrive domestically in the development of cell therapy. This can also foster medical tourism. So, people from Singapore, Malaysia, and Thailand can come to Indonesia for treatment or to receive stem cell therapy or immune cell therapy. For cancer, for health, and for travel at the same time.

"Enjoying the extraordinary nature, which is so beautiful in Indonesia, and also combining this cell therapy with traditional Indonesian natural therapies. Herbal medicine, aromatherapy, massage, and so on. This is our hope, and of course, the same is true for Indonesia, right? The government, of course. The next step is to develop current therapies beyond that," he explained.

Furthermore, he and his team have a vision and mission regarding gene therapy. So, what is this gene therapy for? For patients with thalassemia. Indonesia is a global hotspot for thalassemia, and there are many thalassemia patients in Indonesia.

"If thalassemia can be cured with gene therapy? Well, that's our hope too. Also, how can curable degenerative diseases like Parkinson's and so on return to a healthy, normal life? By simply using this cell therapy, that can happen. Why? We all know that the first three pillars are drugs, biological drugs, and one more medical device, all of which are man-made. Cell therapy, is it man-made? Yes, the factory. But cells are living things. Cells move," he added.

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Ultimately, Dr. Sandy Qlintang observed that our entire body contains tens of trillions of cells. All of them are God's creation. Therefore, if you want to use cell therapy, pray before beginning. This allows for the miracle of healing that works through the living cells within our bodies.

"Although stem cells can repair our body's cells, their effectiveness is reduced if not combined with a healthy lifestyle. For example, if we don't maintain a healthy diet, exercise, and sleep patterns, the repaired cells can become damaged again, necessitating repeated stem cell therapy."