Health system matters

IN 1978, 134 countries, 67 international organizations and many non-governmental organizations participated in an international conference at Alma-Ata, now Almaty, in Kazakhstan, and came up with the Declaration of Alma-Ata.

The declaration reaffirmed the World Health Organization (WHO) definition of health—a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity. This argued that attainment of the highest possible level of health requires the action of socioeconomic sectors, in addition to the health sector.

The Alma-Ata declaration deemed inequity as unacceptable and health as a human right, thus called for “Health for All.” From a limited perspective of service delivery—a world only of doctors and hospitals—health was now viewed as an outcome borne out of systematic actions from several actors and stakeholders. Just as it takes a village to raise a child, it takes a health system to ensure health for all.

The WHO defines a health system to consist of all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence socioeconomic determinants of health, as well as more direct health-improving activities. It is more than just public hospitals and health-care facilities delivering personal health services. It includes mothers taking care of their sick children, indigenous peoples seeking treatment from traditional healers, and private hospitals and health-care professionals, private and government health-insurance organizations. It includes the Department of Social Welfare and Development making vaccinations and facility-based deliveries as conditions for cash transfers and the Department of Education promoting oral hygiene and hand washing.

The World Bank (WB) states that individuals and organizations, whether public or private, who are regulators, recipients, purchasers, or providers of services and supplies, are all parts of the health system. These many parts are always inter-connected by the key functions of the health system, which are oversight of the whole health system, health-service provision and promotion, health financing, and management of health-related resources, such as pharmaceuticals, medical equipment and health information.

The attainment of health for all, or universal health coverage, thus requires transformation of all the parts of the health system. The WHO explains this as working on the six building blocks, which are as follows: improving health-service delivery; ensuring responsive health work force; setting up functional health-information systems; expanding access to essential medicines; appropriate health financing; and instituting strong leadership and governance.

Similarly, the WB talks about health-system control knobs, and that transformation of health systems would entail finding the right balance of up to where to move each of the control knobs. It means actions on the five control knobs of organization, financing, provider payment, regulation and persuasion.

Both frameworks are consistent with each other, as both challenges countries to do systematic reforms and not just piecemeal, silo-based and limited changes. Until countries start fully realizing that health system matters, the reforms will not be transformational.

In the next months, I will be describing how the Philippines and other countries in Southeast and East Asia and probably the rest of the world are reforming their respective health systems. We will look into how the Philippines and other countries are working to strengthen the building blocks and to find the appropriate mix of the control knobs.

We will look into where we are as to addressing the traditional public-health diseases of tuberculosis and malaria and the other emerging disease, such as dengue and HIV/AIDS. But beyond the usual number of cases, we will assess how various health-system interventions have contributed (or not) to addressing these public-health problems.

We will explore the role of the private sector—from hospitals to ambulatory health facilities, private physicians, pharmaceutical companies and health maintenance organizations in the reforms. We will delve into the role of development partners, bilateral and multilateral agencies in the reforms. We will discuss how public financing, be it from budget or health insurance, is changing behaviors and practices; look into how primary and preventive care and devolution are ensuring access and affordability of services; and many other stories of health system reforms.

Alma Ata correctly diagnosed that health for all needs changes from all of us. And for us to attain the dream of “Health for All,” we need all parts of the health system to be transformed.

(source: businessmirror.com.ph)

Kemnakertrans Siapkan Lima Draf PP Pelaksana SJSN

JAKARTA – Sampai saat ini, Kementerian Tenaga Kerja dan Transmigrasi (Kemnakertrans) tengah menyiapkan lima draf Peraturan Pemerintah (PP), tiga draf Peraturan Presiden (Perpres) dan satu draf Keputusan Presiden (Kepres) sebagai peraturan pelaksana UU 40 / 2004 tentang Sistem Jaminan Sosial Nasional (SJSN) dan UU 24 / 2011 tentang Badan Penyelenggara Jaminan Sosial (SJSN).

“Tim kita sedang merumuskan semua itu,” kata Kepala Biro Hukum, Kemnakertrans, Soenarno, kepada SP, di kantornya, Selasa (29/1).

Menurut Soenarno, amanat UU 24 / 2011 tentang BPJS, PP yang harus dibuat sebagai pelaksana dua UU tersebut di atas, sebanyak 12 PP, enam Perpres dan satu Keppres.

“Walaupun UU memerintahkan seperti itu, tapi dalam rapat rapat tim kami yang dipimpin Menakertrans pada 21 Januari 2013 bersepakat kami hanya menyiapkan lima draf PP, tiga Perpres dan satu Keppres. Ya kita ringkas saja, dan itu tak menyalahi perintah UU tersebut,” kata Soenarno.

Lima jenis PP yang dimaksud adalah, pertama, PP Penyelenggara Program Jaminan Kesehatan, Kecelakaan Kerja, Kematian dan Hari Tua. Kedua, PP Program Penyelenggaraan Jaminan Pensiun. Ketiga, PP Tata Cara Pengenaan Sanksi Administrasi dan Hubungan Antar Lembaga. Keempat, PP Tata Cara Pengelolaan dan Pengembangan Jaminan Sosial BPJS Ketenagakerjaan. Kelima, PP tentang Tata Cara Transformasi Program dari PT Asabri, PT Taspen ke BPJS Ketenagakerjaan.

Sedangkan tiga draf Perpres yang disiapkan yakni, pertama, Perpres tentang Penahapan Kepesertaan Program Jaminan Sosial. Kedua, Perpres tentang Tata Cara Pemilihan dan Penetapan Dewan Pengawas dan Direksi BPJS Ketenagakerjaan. Ketiga, Perpres tentang Laporan Pengelolaan Program dan Keuangan Tahunan BPJS Ketenagakerjaan.

Sedangkan draf Keppres yang dimaksud adalah Keppres tentang Pembentukan Panitia Seleksi dan Dewan Pengawas BPJS. Soenarno mengatakan, amanat Pasal 63 UU 24 / 2011 UU BPJS adalah direksi dan komisaris PT Jamsostek sekarang akan menjabat secara langsung sebagai direksi dan komisaris BPJS Ketenagakerjaan sejak 1 Juli 2015 sampai dua tahun ke depan yakni sampai 2017.

Ia melanjutkan, tim di Kemnakertrans merumus peraturan pelaksana dua UU tersebut tidak terlepas masukkan dari banyak pihak. “Ada banyak masukkan seperti dari PT Jamsostek,” kata dia. Sebelumnya, PT Jamsostek menyerahkan 10 rancangan PP dan rancangan Perpres terkait pelaksanaan SJSN dan pembentukan BPJS kepada Kemnakertrans.

Kepala Biro Humas PT Jamsostek, Kuswahyudi, mengatakan, usulan itu merupakan bentuk komitmen penuh PT Jamsostek atas implementasi SJSN yang akan dimulai pada Januari 2014 untuk BPJS Kesehatan dan 1 Juli 2015 untuk BPJS Ketenagakerjaan.

PT Jamsostek berinisiatif menyusun draft PP terkait dengan Badan Penyelenggara (BP) Jamsostek. Dirut PT Jamsostek Elvyn G Masassya mengusulkan nama BP Jamsostek untuk menjaga image baik dan kesinambungan program pada BPJS Ketenagakerjaan.

Pengalaman BUMN itu selama 35 tahun merupakan salah satu rujukan utama dalam penyusunan draft seluruh peraturan pelaksana tersebut.

Data kepesertaan dan pelayanan yang ada di PT Jamsostek (Persero) selama 35 tahun penyelenggaraan program jaminan sosial menjadi salah satu modal yang sangat berharga, di luar data-data makro yang telah dikeluarkan oleh institusi lain seperti BPS dan demografi, untuk melakukan kajian perhitungan aktuaria yang komprehensif dan berkelanjutan.

Selain itu, PT Jamsostek juga memperkaya studinya dengan melakukan benchmarking praktik terbaik implementasi jaminan sosial yang ada di luar negeri.

Beberapa acuan utama, antara lain pengalaman Social Security System Filipina untuk penyelenggaraan Jaminan Pensiun dan bisnis proses jaminan sosial mengingat lanskap industri jaminan sosialnya memiliki karakteristik yang hampir sama dengan skema SJSN.

PT Jamsostek juga mempelajari bisnis proses dan skema sistem pengawasan jaminan sosial yang dikembangkan oleh Employee Provident Fund Malaysia sebagai masukan dalam administrasi kepesertaan dan pelayanan jaminan sosial di Malaysia.

Dalam hal pengembangan program, PT Jamsostek mengadopsi standar internasional dari Konvensi ILO Nomor 102 dan panduan internasional yang telah dikeluarkan International Social Security Association (ISSA) kepada seluruh anggotanya untuk penyelenggaraan program jaminan sosial. [SP/Edi Hardum]

(sumber: www.suarapembaruan.com)

The fight to defend Britain’s National Health Service

Britain’s National Health Service (NHS) is suffering death by a thousand cuts and faces wholesale privatisation.

The Conservative-Liberal Democrat coalition has demanded a £20 billion cut by 2015 from an overall budget of £108 billion—a reduction that is impossible without slashing essential life-saving services.

So far, only £6 billion in cuts have been made—mostly one-off savings. Much worse is to follow. But staff levels are already being cut by as much as 20 percent and new labour contracts are being imposed with lower wages and higher workloads.

Accident and Emergency departments (over 30 nationally), children’s units and other wards and facilities are closing—justified by claims that services and medical procedures can be better provided in specialised units. There are no guarantees that such specialised units will not be swamped by demand, or that lives will not be lost due to the distances involved. Yet the medical director of the NHS, Sir Bruce Keogh, dismisses broad opposition to these changes as pressure to “inhibit excellence” and “perpetuate mediocrity.”

The Health and Social Care Act allows private companies to provide health care under the auspices of the NHS and comes in to effect in April 2013. However, this will only escalate a process already underway. The NHS is being bled dry by innumerable private corporations that are fleecing the taxpayer while care is either rationed or denied outright to the chronically ill and the most vulnerable members of society.

On November 13, 2011, Circle Health became the first private corporation to run an NHS hospital. In October 2012, a Freedom of Information request found that in one week alone contracts were signed taking more than 400 community services out of the NHS, including ambulance services, diagnostic testing, podiatry and adult hearing.

Doctors warned that the NHS was being “atomised”, with over 100 health care firms now providing basic care under Any Qualified Provider rules. Some private companies already earn up to £200 million a year each from NHS-funded work.

Sixty NHS Trusts face being declared bankrupt in the next four years, threatening hospitals with “rationalisation” or closure. To fend off this threat, trusts must cut budgets and ration or deny treatments declared to be “of limited clinical value”. Nearly one in five hip replacements and hernia repairs are already handled by private companies. Soon they will have to be paid for.

Cold hard cash is a major factor in the drive to first gut and then privatise the NHS. It will open up massive revenue streams for private medicine, which previously made up just 8 percent of the health sector and was for decades almost entirely parasitic—a form of glorified queue-jumping for the better-off, using NHS taxpayer-funded facilities and doctors trained at public expense.

The NHS is hated by the ruling class as a symbol of everything they were forced to grant the working class in Britain in the post-war period—the “cradle to grave” welfare reforms—in order to placate demands for social change.

It is even now an object of hatred for the political and business elite in the United States, where bitter denunciations of “socialised medicine” conceal the fact that the NHS is still, thanks to being free at the point of delivery and based on clinical need and not the ability to pay, one of the best in the world for the standard of care provided, while America is one of the worst. This is despite spending nearly £5,000 per capita in the US, compared with just over £2,000 in the UK.

These figures provide some indication of the quality of health care that could be provided under a truly socialist health system, integrated into a socialist economy in which the corporations and banks were publicly owned and democratically controlled.

Working people depend on the NHS for their lives and health and want to fight for it. But, as with all fundamental tasks workers face—the defence of jobs, wages, essential services and benefits—this desire is thwarted at every turn by the trade unions and parties once associated with such struggles.

The Labour Party presided over the creation of the NHS in 1948, but spent 13 years in office from 1997 on undermining it. Privatisation by stealth first began in 1989 with the introduction of the “internal market” by Margaret Thatcher. However, it was the last Labour government that encouraged outsourcing of medical services and used the Private Finance Initiative to build hospitals that cost multiple times their initial outlay, saddling these institutions with massive debts for facilities that often had up to 28 percent fewer beds. Labour is now seeking to pose once again as the friend of the NHS, but this is a worthless fraud.

As for the trade unions, none of them has lifted a finger in defence of jobs and services—confining workers to signing petitions, writing letters to MPs, and participating in campaigns to keep open this or that hospital or unit so that the axe falls somewhere else.

How could it be otherwise? The universal experience of workers the world over is that social democratic parties have become indistinguishable from their conservative counterparts, while the trade unions stifle and betray any and all expressions of resistance to government austerity measures, corporate downsizing and speed-up.

In Greece, the social democratic PSAOK and the Democratic Left sit in government with the conservative New Democracy, presiding over austerity measures that include the near-total collapse of public health care.

The Socialist Equality Party in the UK has initiated the NHS FightBack Campaign, based upon the independent political mobilisation of the working class. The SEP campaign insists:

“The defence of health care and every other basic social right can be taken forward only through a break from the unions and the Labour Party. Action committees must be formed by patients, hospital staff and the workers and youth whose lives and health are being jeopardised. The problem is not a lack of funds or resources, but the monopoly of wealth by the super-rich. This monopoly can be broken only by a mass movement of the working class to bring down the coalition government and replace it by a workers’ government based on socialist policies.

“Such a government would carry through a radical redistribution of wealth in favour of working people, which would include ending the obscenity of medicine-for-profit and restoring the health service as a free, high quality state-run facility for all.”

This is the basic perspective upon which every fight by the working class in every country must now proceed.

(source: www.wsws.org)

Indonesia Peringkat III Penderita Hepatitis B di Dunia

Medan (Analisa). Indonesia peringkat ketiga penderita Hepatitis B di dunia. Penyebabnya masih rendahnya pengetahuan masyarakat akan pentingnya kesehatan individu dan kurangnya sosialisasi tentang hepatitis B.

Demikian diungkapkan ahli penyakit dalam dr Ilhamd Sp.PD dihadapan Keluarga Besar Institut Teknologi Medan (ITM), belumlama di ruang rapat Kampus ITM.

Seminar Awam tentang Pencernaan Sehat, Organ Hati Terjaga itu dilaksanakan ITM dihadiri Rektor ITM Prof Dr Ilmi Abdullah, Kepala Humas ITM M Vivahmi Manafsyah SH MSi, Pembantu Rektor (PR I) Supriatno ST MT, PR II M Munajat SE M.Si, para dosen di lingkungan ITM.

Lebih lanjjut, dr Ilhamd Sp.PD mengatakan hepatitis B tanpa gejala dan paling sulit disembuhkan sebab hepatitis yang menahun sebagian besar tanpa gejala.

Untuk pasien hepatitis B ini diajurkan untuk melakukan konsultasi ke dokter ahli. Biasanya penderita hepatitis B parah kerap mengalami seperti muntah darah, buang air besar darah dan perut buncit.

Penularan

Penularan horisontal katanya, dapat ditularkan kepada anggota dari keluarga, teman dan kolega kerja, dan hepatitis B dan A bisa divaksinasi, seperti bayi yang baru lahir, tenaga kesehatan, semua orang yang belum divaksin, anggota keluarga penderita Hepatitis B, anggota angkatan bersenjata dan kaum homoseks.

“Vaksin yang direkomendasikan adalah vaksin dengan rekayasa genetik dari virus hepatitis B dan vaksin yang tidak menimbulkan efek samping, katanya seraya menyarankan usia diatas 40 tahun disarankan untuk memulai menjaga kesehatan.

Rektor ITM Prof Dr Ilmi Abdullah mengatakan, Seminar Awam ini akan rutin dilakukan. Seminar yang diikuti dengan pemeriksaan gula darah, kolesterol, dan asam urat, katanya bertujuan untuk menjaga kesehatan.

“Bila kesehatan kita baik, secara otomatis semua kegiatan yang kita lakukan akan berjalan dengan baik dan lancar,”kata Prof Ilmi

Disebutkannya kesehatan reproduksi dan organ manusia saat ini menjadi bagian penting dari pengetahuan kesehatan khususnya orang awam. Oleh karenanya, pengetahuan berbasis akademik ini setidaknya bisa menularkan ilmu dalam menjaga kesehatan diri dan kelompok terutama di keluarga, tetangga, masyarakat, bangsa dan negara.

“Civitas akademika ITM dan keluarga besarnya terus menggalakkan program kesehatan dan peningkatan kualitas kesehatan baik dosen, mahasiswa dan pegawai,” jelas Prof Ilmi.(twh/rel)

(sumber: www.analisadaily.com)

INDUSTRI FARMASI: SJSN 2014 Tidak Jelas, Pertumbuhan Melambat

JAKARTA—Ketidakjelasan persiapan pemerintah terkait implementasi Sistem Jaminan Sosial Nasional (SJSN) 2014 membuat pergerakan bisnis farmasi sedikit mengendur. Terget pertumbuhan yang semula 14% direvisi menjadi hanya 12%.

Ketua International Pharmaceutical Manufacturers Group (IPMG) Luthfi Mardiansyah mengatakan ketidakpastian pelaksanaan jaminan kesehatan untuk seluruh masyarakat Indonesia ini membuat pengusaha tiarap terlebih dahulu.

“Saat ini kan belum jelas berapa kisaran harga obat yang akan dibeli oleh pemerintah. Jika benar dapat diimplementasikan dan mempunyai prospek cukup bagus pada 2019, maka kami akan meningkatkan kapasitas produksi,” kata Luthfi, Kamis (24/1).

Industri farmasi, tambahnya, akan mempersiapkan modal untuk peningkatan kapasitas produksinya menjadi dua kali lipat. Saat ini, kapasitas produksi obat nasional mencapai 100 juta unit obat. Akan tetapi, untuk saat ini industri farmasi masih belum berani memproduksi obat dalam jumlah yang besar.

Luthfi memperkirakan belum akan ada rencana pengembangan yang signifikan dari perusahaan lokal maupun internasional. Industri farmasi masih akan memantau implementasi perihal kebijakan pemerintah ini.

Secara bisnis, lanjutnya, pengusaha industri farmasi belum bisa menghitung captive market. Setelah memproduksi obat dalam jumlah besar, biaya distribusi obat ke daerah juga harus mulai dipikirkan.

Dia berpendapat industri farmasi, yang terdiri dari 200 perusahaan lokal dan 25 perusahaan multinasional, belum tentu akan ikut seluruhnya dalam Badan Penyelenggara Jaminan Sosial (BPJS).

“Jika harga obat yang dibeli oleh pemerintah rendah, mereka masih bisa bekerja sama dengan asuransi komersial. Tentu saja dengan harga yang lebih baik,” pungkasnya. (faa)

(sumber: www.bisnis.com)

Scientists lift moratorium on H5N1 research

International scientists have declared an end to a moratorium on research into mutant forms of the deadly H5N1 bird flu. Since influenza viruses are constantly changing, research is crucial, WHO’s Gregory Härtl told DW.

DW: There has been this open letter in the journal Science and Nature that international scientists are going to lift their voluntary moratorium on certain research. First of all, what’s the reaction from the World Health Organization (WHO)? Is this a good or a bad thing?

Gregory Härtl: Well, certainly it’s to be expected. We convened a meeting with Dr Fouchier and Dr Kawaoka and others directly involved in this research a year ago, right at the time when this moratorium was announced. And the fact that they have desisted from doing any research on H5N1 for a year now – so twice as long as originally envisaged – has given the influenza and virology world a lot of time to sit back and look at what needs to be done in order to do this research in a surer environment and to do things that can help raise confidence all around.

The moratorium was imposed because of fears that terrorists could get access to what was being researched. Is there any proof to say that the moratorium has worked in that sense – that it’s stopped those sorts of things happening?

What basically is at issue here is understanding the benefits and risks of what we call dual-use research. So obviously with something like H5N1 and working to make it more transmissible among mammals, which is what these two studies did, it helps us understand much better how the virus might become more transmissible. And we can maybe develop a better vaccine or we can see markers developing in the environment when we do our studies that will help us to take precautionary and preventative actions beforehand.

Certainly, yes, in the wrong hands, the fear was that this could have been used as a terrorist instrument and this is why a lot of people were looking at it. In the interim there’s been a lot of work done on developing laboratory guidelines. There’s also been a lot of discussion about what’s happened, and the year has given us a lot of breathing space. And it’s to be expected that the researchers would start the research again and from a public health point of view it’s necessary that they do this.

This open letter is signed by scientists around the world – the US, China, Japan, the UK, the Netherlands, Canada, Hong Kong, Italy and Germany – is there an issue at stake here in terms of the security in laboratories? Has that issue been resolved?

There are guidelines by WHO on how to make laboratories secure and what constitutes a secure laboratory. These regulations are implemented nationally, not by WHO.

But are we seeing cases where those guidelines are not being adhered to? Let’s just take the European countries for now.

I would say not – the guidelines certainly would be stuck to.

Foto

So European laboratories are secure. And what we’re hearing is that now with the moratorium lifted, we can expect some very creative experiments and creative research. What do you think we can expect?

Let’s be realistic here. First of all, laboratory security is very good, it has always been very good. And there will not be anything done overnight which radically changes the way a virus works, so be reasonable.

Be reasonable? But still, what can we expect? There is an expectation still that it’s very likely that flu pandemics will break out and that we are still at risk and we still do not have an entirely steadfast resolution for this issue, given that it does always mutate and change. So what would be fair to expect?

What would be fair to expect in Europe is that there are very secure laboratories from which the risk would be extremely small that any virus would escape or get out. So from that point of view laboratory security in Europe is very high. From the point of view of doing research on influenza viruses, it is extremely important to do this research from a public health point of view, because influenza viruses do constantly mutate and we need to know how they mutate and in what way those mutations might make these viruses more transmissible between humans.

Gregory Härtl is with the Director-General’s office at the World Health Organization (WHO) in Geneva.

(source: www.dw.de)

Kemkes Dorong BUMN Terapkan Efisiensi Kesehatan

Semarang – Wakil Menteri Kesehatan Ali Ghufron Mukti mengatakan, pihaknya mendorong badan usaha milik negara (BUMN) menerapkan efisiensi biaya kesehatan, tanpa mengurangi mutu layanan.

“BUMN merupakan lembaga yang strategis yang diharapkan bisa melakukan perubahan dan perbaikan dalam kesehatan karyawan dengan prinsip efisien, efektif, berkelanjutan, dan adil,” katanya, di Semarang, Senin malam (21/1), sebagaimana dilapokan Antara.

Hal itu diungkapkannya, saat konferensi pers workshop “Peran Serta BUMN Dalam Revitalisasi Dokter Primer Untuk Memperkuat Sistem Kesehatan Nasional” yang diprakarsai PT Pertamina di Hotel Patra Jasa Semarang.

Ali mengatakan, PT Pertamina sudah menerapkan sistem “manage care”, tetapi upaya menegakkan kebijakan pengendalian biaya kesehatan, termasuk obat akan lebih efektif apabila dikerjakan bersama-sama kalangan BUMN.

Ia mencontohkan, kebijakan Presiden Amerika Serikat Barack Obama yang melakukan reformasi sistem pelayanan jaminan kesehatan, sebab aspek kesehatan sangat berpengaruh terhadap produktivitas pekerja.

Di AS, kata dia, untuk produksi satu unit mobil setidaknya membutuhkan biaya sekitar 1.200 dollar AS untuk kelengkapan komponen kesehatannya, sementara di Jepang berkisar 600 dollar AS untuk setiap unit mobil.

“Indonesia masih kalah. Untuk itu, diperlukan pengendalian biaya kesehatan, agar lebih holistik, efisien, efektif, dan adil. Program efisiensi kesehatan di BUMN ini sejalan dengan program Kemkes,” kata Ali.

Senada dengan itu, Pelaksana Tugas (Plt) Deputi Menteri BUMN Bidang Jasa Gatot Trihargo mengakui peran vital BUMN untuk melakukan efisiensi biaya kesehatan karyawannya, seperti yang dilakukan PT Pertamina.

“Untuk mendorong ini, kami sinergikan seluruh potensi BUMN, termasuk tranformasi PT Askes menjadi badan penyelenggara jaminan sosial (BPJS) kesehatan, sementara PT Jamsostek menjadi BPJS ketenagakerjaan,” katanya.

Dalam proses tranformasi dua BUMN itu, kata dia, tentunya ada beberapa penyediaan jaminan kesehatan yang sebelumnya ditangani PT Jamsostek dialihkan ke PT Askes sehingga layanan yang diberikan semakin prima.

Berkaitan dengan efisiensi biaya kesehatan, ia menjelaskan BUMN memiliki banyak potensi kesehatan yang bisa layanannya bisa diintegrasikan, dikonsolidasikan, dan disinergikan agar lebih efektif dan efisien.

“BUMN memiliki dua fungsi dalam jaminan kesehatan, baik sebagai peserta maupun penyedia. Kita (pemerintah) punya apotek, mulai PT Kimia Farma, PT Bio Farma, dan sebagainya. Rumah sakit kita juga punya,” kata Gatot. (TMA)

(sumber: www.gatra.com)

WHO Executive Board appoints new Regional Director for the Americas

22 JANUARY 2013 | GENEVA – The WHO Executive Board, currently holding its 132nd session in Geneva, has appointed Dr Carissa Etienne as the new Regional Director for WHO’s Americas Region (WHO/AMRO), following her nomination by the Regional Committee for the Americas in September 2012. Dr Etienne will take up her appointment for a five-year term on 1 February 2013, succeeding Dr Mirta Roses Periago of Argentina.

“I believe strongly that good health is rooted in equity, universality, solidarity and inclusiveness,” said Dr Etienne in her acceptance speech. “I have learned that Universal Health Coverage is not only the best way to improve the health of every citizen in a country – but that it is entirely feasible.”

Dr Etienne, from Dominica, holds degrees in medicine and surgery from the University of the West Indies as well as a master’s in community health and an honorary diploma in public health from the London School of Hygiene and Tropical Medicine.

In her native country she served twice as Chief Medical Officer (in 2000-2002 and 1995-1996), Director of Primary Health Care Services, Disaster Coordinator, and National Epidemiologist in the Ministry of Health. She also served as Coordinator of the National AIDS Programme, Chairperson of the National AIDS Committee, and Medical Director of the Princess Margaret Hospital, and was an Associate Professor at the Ross University School of Medicine.

From 2003-2008, Dr Etienne served as Assistant Director of the Pan American Health Organization, WHO’s Regional Office for the Americas, and from 2008-2012 she was Assistant Director-General, Health Systems and Services, at WHO headquarters in Geneva.

In Geneva, Dr Etienne led efforts to renew primary health care (PHC) at the global level and to strengthen health systems based on PHC, promoting integration and improved functioning of health systems. She has also promoted policy directions to reduce health inequalities and advance health for all through universal coverage, people-centred care, the access to safe and effective medical products and technology, the integration of health into broader public policies, and inclusive and participatory health leadership.

The Regional Office for the Americas comprises 38 Member States stretching from the Arctic to the Tierra del Fuego: Antigua and Barbuda, Argentina, Bahamas, Barbados, Belize, Bolivia (Plurinational State of), Brazil, Canada, Chile, Columbia, Costa Rica, Cuba, Dominica, Dominican Republic, Ecuador, El Salvador, France, Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Netherlands, Nicaragua, Panama, Paraguay, Peru, Saint Lucia, St. Vincent and the Grenadines, St. Kitts and Nevis, Suriname, Trinidad and Tobago, United Kingdom, United States of America, Uruguay and Venezuela (Bolivarian Republic of). In addition, Puerto Rico is an Associate Member, while Spain and Portugal are Observer States in the Region.

(source: www.who.int)

Waspadai KLB Penyakit Menular Pasca Banjir

[JAKARTA] Intensitas hujan yang tinggi tidak hanya menyebabkan banjir,melainkan juga memicu berbagai penyakit menular. Menteri Kesehatan Nafsiah Mboi mengingatkan petugas kesehatan dan mengimbau masyarakat untuk mewaspadai serta mencegah Kejadian Luar Biasa (KLB) penyakit menular yang kemungkinan bisa terjadi pascabencana banjir di Jakarta.

“Walaupun itu belum terjadi,tetapi tetap harus diwaspadai karena kemungkinan bisa muncul baik pada saat bencana maupun pascabencana. Biasanya yang sering muncul seperti diare,demam berdarah,kolera,leptosporosi,tifus,ispa,” kata Menkes di sela-sela pelepasan 147 tim kesehatan siaga bencana di Kantor Kementerian Kesehatan (Kemkes),Jakarta,Senin (21/1).

Menkes mengatakan, KLB tetap harus diwaspadai sebab sejumlah masyarakat telah menderita penyakit kronis ditambah stress menghadapi bencana,sehingga rentan jatuh sakit. KLB sering muncul pada masa bencana dan berkembang menjadi bencana berikutnya.

“Terutama bagi anak-anak sebisa mungkin menyediakan permainan yang edutaiment untuk mencegah mereka terlalu lama bermain di banjir dan rentan terpapar berbagai penyakit menular,” katanya.

KLB pascabencana,kata Menkes,terakhir dilaporkan pada tahun 2007 yaitu diare di Koja,Jakarta Utara. Menurutnya, KLB pascabanjir biasa terjadi karena sampah. Karena itu para petugas kesehatan diimbau untuk mengorganisir masyarakat agar berperilaku hidup bersih dan sehat guna mencegah terpapar berbagai penyakit. Sebab,kata Menkes,semua penyakit berteman dengan jorok. Semakin jorok individu seseorang semakin banyak bibit penyakit. Sejauh ini penyakit yang paling banyak muncul adalah batuk dan pilek.

Petugas surveilens epidemiologi juga diminta untuk memantau ketersediaan air minum dan mengawasi higienitas sanitasi,terutama pada saat mengolah dan menyajikan makanan untuk mencegah KLB keracunan makanan.

Tim siaga bencana ini terdiri dari dokter, perawat, apoteker, asisten apoteker, tenaga kesehatan lingkungan, dan kesehatan masyarakat. Tim ini merupakan batch kedua, yang berfokus kepada penanganan masalah kesehatan pascabencana, penyakit pascabanjir seperti gatal kulit, flu, batuk, diare, ispa, bahkan leptospirosis. Selain itu, juga menyentuh rehabilitasi korban secara psikologis.

Kepada tim ini Menkes mengimbau agar tetap bekerja dengan professional sesuai standar, prosedur, dan aturan yang berlaku dalam membantu korban bencana banjir, serta tetap menjaga kesehatan diri sendiri.

Sebagai bentuk tanggap bencana, Kemenkes memberikan bantuan, antara lain mengirimkan 10 ton Makanan Pendamping Air Susu Ibu (MP-ASI), mendirikan 4 rumah sakit lapangan, mengirimkan 2.850 individual kit, yang terdiri dari Hygine Kit, Kit Ibu hamil, Kit Ibu bersalin, dan Kit Bayi. Mengirimkan bantuan obat-obatan sebanyak 30 paket, dimana setiap paket dapat digunakan untuk 200–300 pasien, serum antibisa ular; serta mengirimkan 100 tenaga siaga bencana terdiri dari dokter, perawat dan petugas kesehatan masyarakat tahap pertama.

“Sejauh ini ketersediaan obat-obatan,termasuk serum antibisa ular masih tersedia. Selain itu ada 136 posko kesehatan, dan semua rumah sakit pemerintah serta puskesmas di wilayah DKI,termasuk Jawa Barat disiagakan 24 jam,” kata Menkes.

Sementara itu, Kepala Dinas Kesehatan (Dinkes) DKI Jakarta Dien Emawati,mengatakan,mengantisipasi bencana banjir susulan pihak masih siaga 24 jam hingga intensitas hujan berkurang.

“Posko kesehatan dan jajaran saya tetap disiagakan 24 jam,walaupun nanti ada liburan. Gubernur sudah menginstruksikan agar tiga komponen petugas siaga di tempat, yaitu kesehatan,sosial dan tim evakuasi,” katanya.[D-13]

(sumber: www.suarapembaruan.com)

International health cooperation delivering progress in spite of adversity – UN official

21 January 2013 – International cooperation on health is delivering positive results at a time when the world is dealing with multiple challenges such as difficult weather conditions, conflict and economic austerity, a senior United Nations official said today, calling on countries to continue their efforts to improve public health.

“The climate is changing. Antibiotics are failing. The world population keeps getting bigger and older […] costs are soaring at a time of nearly universal austerity,” the Director-General of the World Health Organization (WHO), Margaret Chan, said in her report to the agency’s Executive Board in Geneva. “The challenges facing public health are big and increasingly universal, but they are not insurmountable.”

Dr. Chan stressed that new challenges need new instruments and approaches, and noted how innovation has allowed for significant progress, reducing the spread of diseases such as meningitis.

As of December, 100 million Africans had received a new conjugate vaccine to protect them from meningitis through a joint WHO project, leading to a dramatic drop in cases in 10 countries, Dr. Chan noted, and a new diagnostic tool for tuberculosis has been made more affordable through financial support from WHO partners, allowing it to be used in more than 70 countries.

Economic uncertainty has led to new health programmes that are equally ambitious while being more mindful of costs to affected countries and the international donor community, she said.

“At a time when funding is precarious, it is particularly encouraging to see how programmes are using new research to set ever higher goals,” she said. In particular, she pointed to scientific breakthroughs for HIV, which are more accessible to larger numbers of people at lower costs.

“The range of interventions has expanded dramatically. Safer, more robust antiretroviral therapy is now available even in the world’s poorest countries.”

WHO is also working with countries to help them make better use of their legislation and regulations to reduce the source of health threats, through treaties such as the first protocol to the WHO Framework Convention on Tobacco Control that was adopted in November and aims to eliminate illicit trade in tobacco products.

The protocol treaty, Dr. Chan underlined, “is a watershed event in its own right. It is also a model of what can be achieved when multiple sectors of government, including trade, finance, the environment, customs, law enforcement, and the judicial system, collaborate in the name of health.”

Collaboration from the private sector and non-governmental organizations is also necessary, as they help to increase accessibility and affordability of vaccines and medicines, and raise awareness of health measures, Dr. Chan said.

Private companies have so far committed more than $18 million to strengthen pandemic preparedness and in December one of the three largest manufacturers of influenza vaccines, GlaxoSmithKline signed an agreement with WHO to give the agency access to 10 per cent of its total production of pandemic vaccines, in real time. This means that, as the vaccines roll out of production, every 10th dose goes to WHO for distribution to countries most in need. The company has further agreed to give WHO up to 10 million treatment courses of antiviral medicine.

“These are truly first-time, breakthrough achievements,” Dr. Chan said. “They mark the beginning of a new approach to establishing a structured and predictable process for ensuring fair access to medical products during an emergency, and strengthening preparedness.”

While much progress has been made, there remains a lot to be done to eliminate diseases such as malaria and polio, and address other pressing health issues, including non-communicable diseases such as diabetes. Commitment, accountability, transparency and continuous engagement are required from Member States to achieve this, Dr. Chan stated, as she asked Member States to continue supporting the agency this year.

“International health cooperation is doing much good, despite a world climate of austerity and adversity. A WHO that performs with greater efficiency and effectiveness will make that good even better.”

(source: www.un.org)