The Joint National and International Surveillance Review of Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) Sentinel Surveillance in Indonesia

The Global Influenza Strategy 2019-2030, building on the success of  the Global Influenza Surveillance and Response System (GISRS) and the Pandemic Influenza Preparedness (PIP) Framework, outlines a holistic approach to influenza from surveillance to disease prevention and control for the WHO, countries and partners. As part of the regional effort for effective implementation of the global influenza strategy, the Southeast Asia Regional Office (SEARO) coordinated the Joint National and International Surveillance Review of Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) Sentinel Surveillance in Indonesia from 29^th July- 2^nd August 2024.

The primary objectives of the joint national and international surveillance review were as follows:

• To review the ILI/SARI sentinel surveillance in alignment with globally recommended surveillance standards for influenza and ensure end-to-end integration with SARS-CoV-2
• To assess the current status of the National Influenza Center (NIC) in Indonesia to document its strengths, and to identify areas where further improvements are required to sustain quality laboratory testing, taking into consideration the need for integrated respiratory surveillance for influenza and other pathogens
• To provide recommendations to further strengthening ILI/SARI Surveillance line with the Global influenza strategy, Pandemic Influenza Preparedness (PIP) framework and the Preparedness and Resilience for Emerging Threats (PRET) initiative.

 The review team, comprising national and international experts on surveillance and laboratory practices, included:

• Two surveillance experts from the Southeast Asia region (Bangladesh and Nepal)
• Two laboratory experts from NICs (India and Sri Lanka)
• Two experts from the Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia (WHO CC)
• One expert from the US-CDC, Thailand office
• National experts from Indonesia (surveillance and laboratory leads)
• WHO Secretariat

Three teams conducted the assessment. The team of laboratory experts carried out the evaluation at the National Reference Laboratory—Balai Besar Laboratorium Biologi Kesehatan (BBLBK), Jakarta. Meanwhile, the other two teams assessed sentinel surveillance sites, including ILI sites (PKM Tanah Abang and Padasuka PKM, Bandung) and SARI sites (Hasan Sadikin Hospital and Sulianti Saroso Hospital).The mission acknowledged the expansion of GISRS for sustained integration of influenza and SARS-CoV-2 and future inclusion of other respiratory viruses into broad respiratory virus surveillance and response activities in Indonesia and provided the following overarching recommendations:

• Further enhance joint leadership and coordination among the Directorate of Communicable Disease Prevention and Control, the Directorate of Surveillance and Health Quarantine, the National Biology Health Laboratory, and the Directorate of Public Health Management. 
• Strengthen and optimize the existing ILI/SARI surveillance system through regular reviews to monitor virological changes, better understand disease epidemiology, and enhance outbreak and pandemic preparedness, thereby informing public health responses for influenza and other respiratory pathogens. 
• Empower the National Biology Health Laboratory (BBLBK) NIC to serve as the technical lead (national reference laboratory), responsible for coordinating and enhancing the capacity for quality-assured testing across the regional network, in alignment with the NIC terms of reference.

The mission also highlighted the pivotal role of mobilising the PIP Partnership Contribution Fund in complementing the Ministry of Health’s efforts to implement these recommendations and further strengthen influenza surveillance in Indonesia.

Publication: The Joint National and International Surveillance Review of Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) Sentinel Surveillance in Indonesia

Photos from the mission:

Image:  Joint national and international surveillance review (Review team 1 )  team visiting a ILI  sentinel surveillance   Site  at PKM Tanah Abang, Jakarta.

Image:  Joint national and international surveillance review  team (review team 2 ) visiting the  SARI sentinel  Site at the  Professor ( Dr)  Sulianti Saroso Infectious Disease Hospital, Jakarta.

Caption: Joint national and international surveillance review team  (Review team 3 )  visiting the National Influenza Centre  in Jakarta, Indonesia