In November 2024 through January 2025 the Indonesian Ministry of Health (MoH) and World Health Organization (WHO) launched the country’s first national survey to tackle antimicrobial resistance (AMR) in bloodstream infections (BSIs), which are a core focus of the WHO Global Antimicrobial Resistance and Use Surveillance System and a key Sustainable Development Goal indicator. This marks a crucial step forward in addressing one of Indonesia’s and the world’s greatest health and development threats.
Globally, in 2019 AMR was directly responsible for an estimated 1.27 million deaths and contributed to an estimated 4.97 million deaths. The misuse and overuse of antimicrobials in humans, animals and plants are the main drivers in the development of drug-resistant pathogens, which disproportionately impact low- and middle-income countries, including Indonesia. By 2030, Indonesia is projected to be among five countries globally with the highest percentage increase in antimicrobial consumption.
Since 2017, Indonesia has implemented a national multisectoral plan to address AMR and last year launched the world’s first human health-sector specific plan to address AMR based on WHO’s people-centred approach. However, Indonesia’s network of more than 3000 acute-care hospitals continues to struggle with patchy surveillance and incomplete data, highlighting the critical importance of the joint MoH-WHO initiative.
“The information we gather from this survey will be instrumental in refining our treatment protocols and shaping effective policy responses to AMR,” said Dr Maria Endang Sumiwi, MPH, Director General for Primary Care and Community Health, at the 27 November 2024 launch event in Jakarta.
The survey spans 80 hospitals and 30 laboratories across 25 districts in 16 provinces. It targets around 10 000 patients. Researchers expect to identify approximately 1000 positive blood cultures and 270 confirmed BSIs. A control group of 1000 non-infected patients will provide a benchmark to assess the health and economic impacts of AMR.
Strengthening national laboratory and surveillance capacity is a key component of the project. To date, more than 270 health care workers from across Indonesia have been trained in survey methodologies, blood culture techniques and antimicrobial susceptibility testing, with critical support from Thailand-based WHO experts. In January 2025, Surabaya’s National Reference Laboratory hosted intensive practical training for 30 technicians, with a focus on quality control.
“The national AMR BSI survey is essential to MoH and WHO efforts to build a sustainable and comprehensive national surveillance system capable of monitoring both drug-susceptible and drug-resistant infections,” said Professor Roderick Salenga, Team Lead for Health Systems at WHO Indonesia. “The evidence gathered will directly inform the development of more effective treatment guidelines and public health policies, ensuring that Indonesia not only adapts to AMR’s challenges but actively works to reverse its spread.”
Data collection on AMR BSIs will continue throughout 2025, providing critical insights into resistance patterns and their economic impact across the country. The survey will complement and inform medium and long-term MoH and WHO efforts to tackle AMR, with a focus on strengthening treatment protocols, enhancing hospital preparedness and shaping responsive public health policies. This will ensure that Indonesia continues to lead globally in the battle against one of humanity’s greatest health and development threats, for stronger health systems and improved patient outcomes.
_____________________________________________________________________________________________
Written by Nora Arista, National Professional Officer (AMR), WHO Indonesia