Heart Illustration

Prevention is better than cure. That’s the core message Indonesian public health experts are promoting with strengthened health regulations

“WHAT must be done is to prevent it from an early age,” said the PB Management of the Indonesian Doctors Association (IDI) and PP of the Indonesian Public Health Association (IAKMI) Dr. Iqbal Mochtar on Sunday 27th November 2022. This step can be done by strengthening health regulations that limit the use of cigarettes and consumption of sugar, salt, fat (GGL).

He mentioned, in various countries there are national obesity prevention programs to control blood pressure, diet and exercise of its citizens. That, said Iqbal, does not yet exist in Indonesia.

The government also has not completely limited cigarette consumption and advertising even though it is a major risk factor for coronary heart disease. “On the one hand the government allows smoking to develop and on the other hand it wants to treat it. The result is paradoxical,” he said.

Likewise with the consumption of salt, sugar, fat (GGL) which should be strictly regulated from sales and public consumption.

“This is the upstream, this is what must be prioritized. Prevention is more important than treatment and more efficient. Other countries have national programs,” he said.

Based on the 2014-2019 Global Burden of Disease and the Institute for Health Metrics and Evaluation (IHME), heart disease is the highest cause of death in Indonesia. Meanwhile, Basic Health Research (Riskesdas) data for 2013 and 2018 shows an increasing trend of heart disease, namely 0.5% in 2013 to 1.5% in 2018.

Even heart disease is the biggest cost burden. Based on BPJS Health data, in 2021 the largest health financing will be for heart disease, around IDR 7.7 trillion.

Head of the Ministry of Health’s Communication and Public Service Bureau Dr. Siti Nadia Tarmizi said that so far, the Ministry of Health has socialized and encouraged people to do a lot of physical activity. This is an effort to prevent heart disease and other non-communicable diseases (PTM).

“This is an increase in screening for Non-Communicable Diseases (PTM) on cholesterol, diabetes, and others. Then it encourages people’s physical activity,” he said.

Health Minister Budi Gunadi Sadikin said education in primary care continues to be carried out through campaigns, including campaigns for immunization, balanced nutrition, exercise, anti-smoking, environmental sanitation and hygiene, disease screening and medication adherence.

Apart from prevention, another intervention for the treatment of the heart is ring fitting surgery. Minister of Health Budi requested that ring-pair heart surgery be carried out in 514 regencies/cities to deal with cases of heart disease that continue to increase.

“I asked 514 regencies/cities to be able to operate on ring pairs. All provinces must be able to operate on open heart failure and open brain surgery,” said Budi.

A budget of IDR 31 trillion is needed until 2027 to make 514 regencies/cities able to perform heart surgery. For phase 1 the Ministry of Health provides a budget of IDR 17.9 trillion and IDR 13.1 trillion for phase 2. These are truly large funds.

On the other hand, the effectiveness of the prevention policies carried out by the Ministry of Health through its campaigns is questionable. Since in fact, the number of heart disease continues to increase.

Translated from Indonesia by: Melinda Damayanti
Original article by Media Indonesia: in this link