JAKARTA - Dengue fever (DBD) is still one of the health challenges in Indonesia. Contrary to the assumption that this disease only appears during the rainy season, the risk of dengue transmission can now occur throughout the year.
This condition makes prevention efforts no longer enough to be done seasonally, but needs to be part of people's habits.
In addition to threatening health, dengue also has a major economic impact on patients, families, and the health system.
A recent study from the Center for Financing and Health Insurance Management Policy of the Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University (UGM) estimates that the total economic burden due to dengue in Indonesia in 2024 reaches USD550.9 million or almost Rp9 trillion, with more than two million cases of hospitalization.
UGM researcher, Dr. Diah Ayu Puspandari, M.Kes., MBA., Apt., said that ownership of the National Health Insurance (JKN) has not completely eliminated the burden of costs that patients must bear.
"Our latest study in 2024 shows that the ownership of the National Health Insurance (JKN) has not completely freed patients from the burden of costs. JKN patients still have to spend an average of Rp. 1.1-1.3 million when faced with a period of dengue-related illness for non-medical needs such as transportation and accompanying accommodation, in addition to lost productivity (including lost income). Meanwhile, for patients who do not have insurance, the cost jumps drastically to Rp. 4.3-5.6 million because all medical treatment costs must be borne by themselves," he said.
Not only the cost of treatment, the loss of productivity is also a burden that often escapes attention. When a family member is stricken with dengue, work and school activities are often disrupted because they require assistance during treatment.
Professor of the Faculty of Medicine, University of Indonesia, Prof. Dr. Sri Rezeki Hadinegoro, Sp.A(K), said that the impact needed to be a concern in efforts to handle dengue.
"When one child is infected with dengue and needs treatment in the hospital, parents must accompany so that they lose time to work and reduce productivity. Likewise, if the parents are sick, the family must take care of them and can disrupt the atmosphere and the family's economy. It can be said that in addition to the cost of treatment and medication that must be incurred, another invisible impact is the disruption of productivity; especially for recovery from dengue infection it takes a long time of about 1-2 weeks," he said.
UGM studies also show that the loss of community productivity due to dengue reaches around IDR 1.81 trillion in the JKN participant group throughout 2024. Meanwhile, in the non-JKN group, the loss due to the loss of productive time is estimated to reach around IDR 755 billion.
Seeing the magnitude of the impact, experts assess that dengue prevention needs to be carried out more comprehensively. According to Prof. Sri, disease control can no longer rely solely on eradicating mosquito nests through the 3M Plus movement.
"Facing the threat of dengue disease which is so severe and widespread, we can no longer rely on only one or two conventional prevention efforts such as 3M Plus. We need something comprehensive. There needs to be a strong synergy that integrates vector control, strengthening early diagnosis in health facilities, and the adoption of innovative medical interventions such as vaccination. Only through comprehensive efforts can we build a strong protection for children and the wider community from dengue," he said.
From the economic side of health, vaccination is also considered to have the potential to provide benefits in the long term. Professor of the Department of Pharmacology and Therapy of FK-KMK UGM, Prof. Dr. Jarir At Thobari, D.Pharm., Ph.D., explained the results of the modeling which showed that the implementation of dengue vaccination has the potential to reduce the number of symptomatic cases, hospitalization, and even deaths for 20 years.
"This study shows the importance of looking at the benefits of prevention more comprehensively. From the perspective of health service payers, dengue vaccination is projected to provide health benefits comparable to the costs incurred. Meanwhile, from the perspective of the community, the economic benefits are estimated to be greater because they also take into account the costs borne by families, loss of productivity, and other economic impacts that are not always reflected in the health budget," explained Prof. Jarir.
Based on the results of the modeling, the implementation of dengue vaccination has the potential to generate cost savings of USD329-731 million, or around Rp5.2-11.5 trillion, over 20 years. These findings show that investing in disease prevention not only has the potential to improve public health, but also provides significant economic benefits in the long term.
The commitment to strengthen dengue prevention is also the focus of the Jakarta Dengue Forum, which was held by PT Takeda Innovative Medicines together with the Indonesian Children's Doctors Association (IDAI) DKI Jakarta Branch. The scientific forum was attended by more than 300 health workers to discuss the latest developments related to dengue prevention and treatment in Indonesia.
The Chairman of IDAI Jaya, Prof. Dr. dr. Rismala Dewi, Sp.A(K), emphasized the importance of collaboration between various parties in dealing with dengue.
Dengue is still a health challenge that we need to face together. As a professional organization, IDAI Jaya is committed to continue to support the improvement of understanding and capacity of health workers in the prevention and management of dengue.
Therefore, IDAI Jaya welcomes collaboration with various parties, including through the Jakarta Dengue Forum, as a scientific forum to share updates, strengthen discussions, and encourage more comprehensive prevention efforts.
"We also invite pediatricians to continue to play an active role in educating parents, encouraging early detection, and helping families understand the protective measures that can be taken to reduce the risk and impact of dengue on children," said Prof. Rismala.
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