Tackling Indonesia's Diabetes Challenge
Indonesia is in the midst of a fundamental economic and demographic transition. The country is projected to become one of the top ten economies in the world by 2030, up from the sixteenth largest today. An additional 90 million people are estimated to join the consuming class by 2030. In healthcare, too, Indonesia has made rapid strides, reducing maternal mortality by 56 percent in the last decade and under-five mortality by 86 percent over the past 50 years. An Indonesian’s average life expectancy has increased from 49 years in 1960 to 69 in 2013. World Development Indicators, World Bank, July 2015, worldbank.org. In 2014, Indonesia introduced the world’s largest single-payor health-insurance program, seeking to provide universal healthcare to its approximately 250 million citizens by 2019.
Looking ahead to the next 10 to 15 years, one of Indonesia’s biggest challenges will be addressing non-communicable diseases (NCDs). In 1990, NCDs represented 43 percent of the country’s disease burden, compared with 49 percent for communicable diseases such as tuberculosis. Today, NCDs’ share has grown to 69 percent, Global Burden of Disease database, Institute for Health Metrics and Evaluation, healthdata.org. and the numbers are rising. In 2014, three NCD categories—cardiovascular diseases, diabetes and its complications, and respiratory diseases—accounted for nearly 50 percent of deaths in the country. D. E. Bloom et al., Economics of non-communicable diseases in Indonesia, World Economic Forum, April 2015, weforum.org. These three NCDs will cost Indonesia an estimated $2.8 trillion from 2012 to 2030, according to the World Economic Forum.
The adoption of a modern lifestyle by the Indonesian middle class and the country’s aging population are the main factors behind the increase in NCDs. As elsewhere in the developing and developed world, a modern lifestyle corresponds to a higher calorie intake and sedentary behavior: fewer people walk to work or school, and more people are spending increasing hours in front of televisions or computer screens. By 2030, 135 million Indonesians are forecast to be part of the consuming middle class, compared with 45 million in 2010. Additionally, projections suggest that about 27 percent of Indonesians will be more than 50 years old in 2035, compared with 14 percent in 2000. .World Population Prospects 2015, UN Department of Economic and Social Affairs, July 2015, esa.un.org.
Indonesia is drafting a national agenda to address the growing burden of NCDs. In this report, we focus on diabetes to illustrate the issues the country faces in responding to the rise of NCDs. Our report draws on extensive secondary data, primary research, and perspectives to highlight the country’s diabetes challenge.
This report is not intended to present an exhaustive list of potential diabetes interventions, and it does not evaluate their medical or cost effectiveness. Rather, it is meant to illustrate the scale of Indonesia’s diabetes challenge, highlight initiatives other countries are deploying that may be relevant to Indonesia and could inform Indonesia’s approach, and outline how Indonesia might implement a national diabetes-management strategy.