Download Health education and information center

Preliminary Proposal for Establishing Inter-University Center
on Global Health (IUCGH)
Collaboration between Indonesia and Germany through Debt Swap Batch II
Drafted by: Global Health Team
I.
Introduction
Indonesia is the fourth most populous country in the world and the most populous Muslim
nation. According to the 2010 Census the population consisted of 237,556,363 inhabitants, of
which 119,507,580 males and 118,048,783 females. The archipelago consists of about 17,000
islands straddling the equator and stretching from the Indian Ocean to the Pacific Ocean.
Indonesia experienced a remarkable economic growth during the years preceding the start of the
global financial crisis in 2008. This growth was interrupted by the collapse in trade in late 2008
1
and early 2009. However, the country weathered the global financial crisis relatively smoothly
because of its heavy reliance on domestic consumption as the driver of economic growth.
Increasing investment by both local and foreign investors is also supporting solid growth.
Investor confidence is strong thanks to the governmental efforts to fight corruption and create a
healthy business environment. Although the economy slowed to 4.5% growth in 2009 from the
6%-plus growth rate recorded in 2007 and 2008, by 2010 growth returned to a 6% rate. During the
recession, Indonesia outperformed most of its regional neighbors.
Indonesia still struggles with poverty and unemployment, inadequate infrastructure, corruption,
a complex regulatory environment, and unequal resource distribution among regions. In late
2010, increasing inflation, driven by higher and volatile food prices, posed an increasing
challenge to economic policymakers and threatened to push millions of the near-poor below the
poverty line. In 2012, the government faces the ongoing challenge of improving Indonesia's
infrastructure to remove impediments to growth. Table 1 below provides some economic
indicators.
Indicator
Year
Figure
GDP (official exchange rate in billions , 2010 US$ )
2010
706.7
GDP per capita (2010 US$)
2010
4,200
Population below poverty line
2010
13.33%
Population belonging to Middle class or higher
2010
43%
Unemployment rate
2010
7.1%
Life expectancy at birth, total (years)
2010
71.33
Literacy (age 15 and over can read and write)
2010
90.4%
For 2008, the Ministry of Health reported a life expectancy at birth of 70.5 years, but large
disparities exist among the provinces and regions. While the region of Jakarta and surroundings
showed the highest life expectancy at birth at 75.9 years, followed on its heels by the region of
Yogyakarta at 75.7, the Province of West Nusa Tenggara showed a life expectancy at birth of only
66.3 years. The Human Development Index has steadily increased over the past years.
II.
Preliminary Work at each Institution in Indonesia
A.
Gadjah Mada University (UGM)
The vision of UGM to be a World Class Research University had strengtht the effort of many
faculties to create a condusive environment for improvement in quality and quality and also
the dissemination of the result of research. The initiation of many research cooperation, the
2
establishment and research activities in Faculty of Medicine of UGM and the involvement of
lecturers and students from graduate, postgraduate and doctoral level in the reserach, and the
developmnet of publication media to distribute such as journal, newsletter and books.
Research unit also being formed to coordinate, inventarize, and disseminate the activities, and
also tom provide financial resources from the increase need and offer for reserach. In this
research activity, Faculty of Medicine of UGM have held many researches with the ability
able to serve diagnostic, therapeutic, and prognostic modalities such as the development of
dengue infection, virus Epstein-Barr as related with nasopharingeal carcinoma, Human
Papilloma Virus as related with cervical cancer, malaria, monoclonal antibody for filaria. New
tools have also been developed to aid nursing diagnosis and therapy for dengue, malaria,
toxoplasma, filariasis and thalassemia and have also been developed according researches in
mollecular biology, biotechnology, and genetics.
Cooperation with many institutions in supporting the increase of a significantly collaborative
cooperation is increasing each year. In 2008, Faculty of Medicine of UGM have research
founding from grant from Kementerian Ristek, Risbiniptekdok, Departemen Kesehatan,
Pascasarjana DIKTI, Riset Unggulan DIKTI, Hibah Guru Besar and the reserach of the young
lectureres. While the other research data from the outside came from KWF (Netherland),
World Vision, IVI/CDC Atlanta, PATH, WHO, UNICEF, SPIN, DANIDA, US-NAMRU,
World Bank, USAID HIH-fogarty USA, Melinda-Bill Gate, TAHIYA, GTZ, INWENT and
Van Leer. The finance gained were 3,7 billion rupiahs. During 2008, Faculty of Medicine of
UGM have also allocate the founding of 1,2 billions for guidance proposal, research of
postgraduate and doctoral programs, QA research, Ethic and Biosafety Research and founding
45 research titles for senior dan junior staffs by involving 90 lecturers and 155 undergraduate
program.
Faculty of Medicine of UGM is also well known for its reputation in doing cooperation with
other health institutions and medical schools in local and international level. These
institutions are members of some famous networking such as Community Partnerships for
Health through Innovative Education, Service and Research; International Clinical
Epidemiology Network (INCLEN); and International Network for Rational Drug Use
(INRUD), OLVG Amsterdam, Maastricht University, Utrecht Univeristy, Univeristy of
Adelaide, University of Melbourne, University of Newcastle, Harvard Medical School,
University of Saskatchewan, US Naval Medical Research Unit, University of Innsbruck,
3
Umea University, Erasmus University, dan Groningen University, Hogskolan I Boras, Kobe
Women University.
B.
Jenderal Soedirman University (UNSOED)
The SPICE project (UNSOED-Uni-Bremen collaboration) initiative was developed under the
agreement on scientific and technological cooperation between Indonesia and Germany. It
addresses the scientific, social and economic issues related to the management of the
Indonesian coastal ecosystems and their resources. Scientists from research institutions of the
Helmholtz Association, the Leibniz Association and several universities participate in the
SPICE Program. The overall coordination is with the Center for Tropical Marine Ecology
(ZMT), University of Bremen.
The objective of SPICE program are first, strengthen existing data bases on coastal
ecosystems. Second, enhance our understanding of the impacts of natural changes and human
interventions on Indonesian coastal ecosystems. Third, provide a Decision Support System
(DSS) for the conservation and sustainable use of coastal resources and services by
strengthening existing data bases on coastal ecosystems. Fourth, promote capacity and
infrastructure building in the marine sector in Indonesia and Germany. Fifth, establish a
network to promote and strengthen public-private partnerships in the management of coastal
resources. This project can be a fundamental basis for further research and development in the
area of climate change and human health as one of main clusters of development of InterUniversity Center on Global Health (IUCGH).
Despite of preliminary fundamental project in climate change, UNSOED has been facilitated
with integrated research laboratory. This laboratory has been equipped with facilities which
can be used for climate change impact analysis and other analysis such as for cancer research
activities:
1.
Molecular biology: Genom Analyzer GAIIx, Cbor, Microbead Reader, Polymerasi Chain
Reaction (PCR), Electrophoresis System, Transilluminator (Gel Doc.), and PCR realtime.
2.
Anorganic
and
organic
chemistry:
spectrophotometer,
atomic
absorption
spectrophotometer (AAS), mercury analyzer (MA), gas chromatography (GC), X-ray
diffraction (X-RD), scanning electron microscope (SEM), amino acid analyzer (AAA),
high performance liquid chromatography (HPLC),
thin layer gas chromatography
(HPTLC); total organic carbon (TOC) analyzers, simultaneous thermal analysis (STA),
forier trans infra red (FT-IR), Kjeltec (Automatic Destilation Unit), fermentor, microbial
impedance.
4
C.
Andalas University (UNAND)
UNAND is one of the leading universities in the field natural biodiversity and herbal
medicine studies in relation to the prevention of non-communicable disease efforts (i.e.
cancer) and UNAND has established natural laboratory facilities. UNAND has already had a
join-collaboration with German Cancer Research Center (DKFZ) in developing research
especially in for local herbal medicine and cancer in particular ethnic.
D.
Mulawarman University (UNMUL)
Center for Climate Change Studies (C3S) is a research center at UNMUL which focuses on
climate change issue in East Kalimantan. As a focal point, C3S has two main concerns:
1. Climate change adaptation
a. Draught, flood and land slide control
b. Food security
c. Increasing sea level monitoring
d. Diseases control related to climate
2. Climate change mitigation
a. Solid waste treatment
b. Waste water treatment
c. Energy alternative
d. Agriculture emission reduction program
e. Forest conservation
f.
E.
Forest fires control in Kalimantan
Diponegoro University (UNDIP)
The Center for Biomedical Research (CEBIOR) has been established in 1999 as a
biotechnology laboratory. CEBIOR has became an authoritative institute in Faculty of
Medicine, Diponegoro University (FMDU). CEBIOR research is focusing on Mental
Retardation and Autism, Disorder of Sex Development, Cancer Genetics, Infertility and
Reproductive Genetics and DNA Polymorphism in infectious diseases such as DHF as well as
Leptospirosis. Other studies in immunology are cytokines and molecular studies on infectious
disease as well as effects of some drugs including herbal medicine. Cooperation with
RUNMC (Radboud University Nijmegen Medical Centre) Netherlands had made CEBIOR
become amazingly better developed than before.
5
To date, CEBIOR stands with 22 staff from various divisions, 6 technicians and 1
administrative staff Countless research projects have been done, frequent partnerships have
been approved. CEBIOR had stated its position strongly nationally. As a center that explores
science actively, CEBIOR keeps on pursuing for more developments and achievements in the
future. All of this is dedicated for achieving Research University.
III. Preliminary Work at Potential Collaborator in Germany
A.
Institute of Public Health (IPH), University of Heidelberg
The Institute of Public Health (IPH) was founded in 1962 and has steadily grown since. It
currently has a staff of about 60, which includes the chair, full professors, assistant professors
(scientists with ‘habilitation’), research associates, support staff (lab technicians, managers
and staff assistants, and a varying number of visiting scholars, post doctoral fellows and
doctoral students. The Institute of Public Health is part of the Medical School/Medical faculty
which in turn is part of the University of Heidelberg. IPH mission statement emphasizes IPH
international perspective with a focus on low and middle income countries. To fulfill this
mission, IPH attach great importance to linking activities in two ways: on the one hand, to
make sure that IPH staff teaches, evaluates development projects in the health sector of low
and middle income countries and participates in research so that their insight and experience
from different activities are enhancing each other. As an example, research results are fed
immediately into lectures; insights from policy evaluation help institute in the design of IPH
own research projects.
On the other hand, IPH seek to look at health and health systems from an international
perspective, linking experience in the north and south. A third linkage IPH cherish at the
Institute is the linkage between different disciplines. Health economists, epidemiologists,
anthropologists, political scientists, sociologists, mathematicians, geographers, management
specialists and biologists work closely together with public health and clinical physicians.
IPH staff is working within six thematic units: epidemiology and biostatistics, health systems
research, global health policies and systems, disease control, global environmental change and
human health, and junior group of health economics and health financing. At the moment, the
issue of global climate change and public health become one of the priorities in IPH research
and education. IPH through INDEPTH international collaboration has a previous jointworking research with Community Health and Nutrition Research Laboratory (CHNRL)
Faculty of Medicine, Gadjah Mada University in Purworejo to develop community laboratory
6
for public health research. This foundation will facilitate and accelerate the development of
IUCGH.
B.
German Cancer Research Center (DKFZ), Heidelberg
German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) is the largest
biomedical research institute in Germany and a member of the Helmholtz Association of
National Research Centers. In over 70 divisions and research groups, our more than 2,500
employees, of which more than 1,000 are scientists, are investigating the mechanisms of
cancer, are identifying cancer risk factors and are trying to find strategies to prevent people
from getting cancer. They are developing novel approaches to make tumor diagnosis more
precise and treatment of cancer patients more successful. The German Cancer Research
Center occupies a leading position in the area of epidemiological studies as well as in
nutrition sciences, biostatistics, and the application of biomarkers (characteristic biological
features that are keys for the prognosis or diagnosis of cancer). DKFZ is excellent research
partner for IUCGH.
C.
Institute of Pharmacy and Molecular Biotechnology (IPMB), University of
Heidelberg
Institute for Pharmacy and Molecular Biotechnology is an institute which covered on the
development, investigation, and application of drugs and bioactive compounds, as well as on
the elucidation of molecular and cellular mechanisms of action. This research integrates
experimental approaches of chemistry, molecular and cellular biology, pharmacology,
bioinformatics, and pharmaceutics. Main research areas of our institute include nucleic acids
as tools and drug targets, development of new anti-infective drugs, molecular evolution &
proteomics, research on neurodegenerative diseases, systems biology as well as drug targeting
and transport. The IPMB also leading institute in study biodiversity traditional medicine and it
applications in modern medicine in collaboration with Faculty of Medicine, University of
Heidelberg and government and universities of China. The IPMB have excellent synergy
system between education and research, they holds the main responsibility for the study
programs in Pharmacy and Molecular Biotechnology in level Bachelor until Doctoral
programs in which about 500 students are currently enrolled. IPMB experienced in managing
education and research would be useful for IUCGH in developing research and education.
7
D.
Institute of International Health, University of Munchen
On June, 9th 2009 the Center for International Health (CIHLMU) was selected as one of five
Centers of Excellence for Development Cooperation (EXCEED) by the German Academic
Exchange Service (DAAD). The Center will be funded by the German Federal Ministry for
Economic Cooperation and Development (BMZ) for a five year period. Within the LudwigMaximilians-Universität, four faculties and 12 institutes are involved. They work together
with more than 50 universities, ministries, the World Health Organization and other
stakeholders in the field of health.
The mission of CIHLMU is to integrate teaching, research, consulting & the practical
implementation of health-related topics in developing countries in order to achieve the
Millennium Development Goals (MDGs). The aim of CIHLMU is to empower partner
universities in developing countries to set their own higher education and research agendas
based upon the local problems. These agendas should be integrated by the partner universities
into a network of knowledge management. Finally, research results will be translated by the
partners into policy to provide crucial information to stakeholders.
IV. Situational Analysis
1.
Climate change
Indonesia lies in equator area and heavily influenced by tropical climate with two distinct
seasons; monsoon wet and dry. Average annual temperature is less variable and ranges from
23–32℃. Indonesia supports tremendous species diversity of both animal and plant life in its
pristine rain forests and its rich coastal and marine areas. Nearly 60% of Indonesia`s terrestrial
area is forested. The landscape is also mountainous and volcanic with over 500 volcanoes out
of which 129 are still active. Indonesia is rich in natural resources and holds at its disposal
deposits of petroleum, natural gas, and metal ores. Indonesia`s macro-economic development
during the past 30 years is to a large extent based on its natural resources. However, these
resources have been exploited unsustainably and communities living in the vicinity of
formerly resource rich areas are experiencing increasing levels of poverty. In 2007, half of the
population lives below the poverty line of US$2 per day, and un- or underemployment rates
are high (27.6%). Because of its size, economic importance and conflict pattern, Indonesia is
of strategic importance to the development and stability of the region as a whole.
As developing country, Indonesia is struggling with the problem of transitional epidemiology
of diseases and other health outcomes attainment. Environment becomes an imminent
8
determinant that contributes to the unfinished eradication of communicable diseases agenda,
and inevitably influences public health status performance in Indonesia. Geographically,
Indonesia which lies in the equator is vulnerable to the impact of global environmental change
on diseases pattern and distribution, for instant, increasing the number of dengue cases which
is in line with increasing temperature in Indonesia from 1968 to 2007. Vulnerability of natural
disaster is also crucial factor which contribute to the high risk of human harm due to its
geographical location. In the last decade as many as 6.8 million people in Indonesia were
affected by various types of natural disasters. Between 2003-2005, 1,430 disasters occurred
including floods, droughts, earthquakes, tsunamis and volcanic eruption. In the 2004 Aceh
tsunami nearly 170,000 people died and in the 2006 Yogyakarta earthquake over 5,700 people
lost their life. Furthermore, landslides are commonly occurring as a result of forest clearance
and town development on land prone to landslides.
Moreover, human man made environment such as industrial zone, mining area, plantation and
other agriculture industries and settlement have destructed the natural equilibrium of
environment which create a problem of the global issue of climate change. Moreover, those
activities have contributed to communicable diseases control. Several activities are also
making the situation worse relating to climate change issues which also increase public health
concern in Indonesia. First, deforestation, trees take carbon dioxide out of the air and produce
oxygen. Contained within carbon dioxide is carbon, which is the major constituent of wood.
Thus forests take CO2 out of the atmosphere and store the carbon in the trees. When trees are
felled, this carbon is either preserved if the wood is used for building, or if the trees simply rot
into the ground. If however the wood is used as firewood or to make charcoal, the carbon is
once again released into the atmosphere as CO2. Second, overgrazing and the use of synthetic
fertilizers, where the soil is fertile, and grasses grow, die down and grow again; carbon is
constantly being added to the soil. Where however the earth is grazed bare, no organic matter
can enter the earth, and in the heat of the sun micro-organisms are even destroyed. In contrast
to natural organic “waste”, synthetic fertilizers add no carbon to the earth. I write “waste” in
this way, because in nature there is no such thing as waste – the so called waste of one animal
or plant is the raw material for another. Third, traffic, transport and packaging, as countries
“develop” they build more roads, import more cars (and therefore petrol), import and export
more goods and use more plastic bags and other packaging.
Increasing the sea level, biodiversity is at risk, diseases pattern and water availability are the
some impacts of global of climate change which need the efforts to mitigate and adapt,
9
particularly in public health point of view. The role of public health as the strategy to deal
with this global issue as follows:
a. Public health role in mitigation
Indonesia has been categorized as one of the largest emitters of greenhouse gases in the
world. In mitigation attempts to reduce greenhouse gas emissions, the involvement of other
sectors is imperative, although the role of health sector cannot be denied. Although the
mitigation to reduce greenhouse gas emissions is not the main area of public health, health
input is still significantly needed. Health professionals and scientists could provide
explanation on the health justification for climate change mitigation and present evidence on
the health impacts of a variety of approaches to climate change mitigation. In Indonesia
however, this role could be appropriately performed by health professionals and scientists, if
they are supported by sufficient resources, facilities, and supplies to conduct high-quality
research. This means that universities, the government, nongovernmental organizations, and
international bodies should work closely to increase capacity to perform interdisciplinary
research. In addition, one of the public health principles, intersectoral collaboration, is
needed. There are some current governmental departments in Indonesia, including
Department of Environment, Department of Transportation, Department of Energy and
Natural Resources, Department of Forestry, and department of Health that could collaborate
with one another.
b. Public health role in adaptation
The efforts to increase people awareness and to empower government to the climate change,
several programs have to be established. First, health promotion, this program will focus on
how to provide communication, information and education to raise awareness of the impact of
climate change to people health status. Integration this effort on public health center will
increase effectiveness and accessibility to all level of people. Second, relocating population in
the small island and coastal which are vulnerable to the natural disaster and other direct
impacts of climate change. Third, surveillance system, the lack of surveillance infrastructure
will create an inability to monitor and to provide further protection toward climate change
impact. Fourth, prevention and preparation for communicable diseases, the opportunity here is
to develop an effective early warning system and preparedness to counter disease outbreaks.
Fifth, health workforce training, to enhance capacity of health human resource to prevent and
create an adequate health care management in response to climate change and its impact on
public health.
10
The lack of awareness and concern regarding the impact of climate change on public health
issues will affect on inability to prevent further negative outcome on human health and
environment. University as an agent for stimulating government as well as people awareness
toward this issue has strategic position to highlight these ideas to other stakeholders.
However, the lack of significant research output from university which might be caused by
the low academic qualification among lecturers in public health, less experience and skill to
conduct a robust research project, unavailability of good quality of the database, and
inadequacy of interdisciplinary research collaboration resulted in the efforts to solve the
problem of climate change in relation to public health in Indonesia are still in question. North
and south collaboration is a good opportunity which can be a plausible bridging program to
enhance research outcomes in Indonesia, especially by establishing between German and
Indonesian universities collaboration.
2.
Cancer
As the WHO notes for Indonesia, the country is currently facing a so-called epidemiological
transition towards NCD, such as cancer. In Indonesia, the added burden of disease for cancer
is associated with high rates of morbidity and is not limited to affluent populations in
urban settings alone, but is also affecting poorer people, reducing their earning capacity and
as such contributing to further impoverishment.
In developing countries such as Indonesia, there are ever-increasing risks of cancer. The
three most important underlying factors are:
a. Growing and ageing population
b. Increase of modifiable risk factors including smoking, western diets and physical
inactivity. 60% of all smokers in the world live in 10 countries, with Indonesia as the
third in the list.
c. Increase of chronic infections, such as stomach, liver and uterine cervix infections.
Apart from lung cancer, which is often palliated with systemic treatment, all most common
types of cancer (breast, colorectal, and nasopharynx) are curable if early detected. However, the
vast majority of detected cases in Indonesia are already beyond a curable stage and only
palliative care can be offered.
Cancer represents a real burden to the country in terms of cost, suffering and human lives.
Cancer has become one of the leading causes of death and disability in Indonesia. In Jakarta,
10.6% of all deaths were caused by cancer in 2006. Every year there is approximately one new
case per every 1,000 inhabitants, equal to a total of 24,600 new cases.
11
The most common types of cancer are breast (13.6%), lung (13%), colorectal (11.5%) and
nasopharynx (4.9%). However, there are big differences in prevalence of types of cancer
between men and women as is shown in Figure below.
The burden of disease for cancer in Indonesia has not been reported accurately as even
cancer patient registration has been low and deficient. The estimated survey results of
Riskesdas (2007) for the total prevalence of tumors/cancers is 4.3 per 1,000 population. With
the Indonesia total population almost reaching 240 million, it is therefore estimated that there
are 1,032,000 cancer/ tumor patients. This shows the need to accelerate capacity of cancer
service in Indonesian Hospital.
The prevalence of tumors/cancers was the highest in 2007 in the Special Region of
Yogyakarta (DIY). Where the national prevalence of tumors/cancers was 4.3 per 1,000
population, the DIY showed a prevalence of 9.6 per 1,000 population. The lowest
prevalence was noted in the Province of the Moluccas (Maluku) at 1.5 per 1,000 population.
One of the reasons for the high prevalence in the DIY of tumors/cancers is actually the
awareness of the population and the fact that tumors/cancers are detected – i.e. the detection
rate is much lower in other provinces.
12
V. Proposed Programs
A. Establishing Inter-Universitiy Center on Global Health (IUCGH) at UGM
The main purposes of establishing IUCGH are translated into several targets which are:
•
To strengthen researches capacity (human resources, finance and infrastructure) on
Global Health at UGM, UNSOED, UNAND, UNMUL, UNDIP.
•
To strengthen research coordination and management on Global Health at UGM,
UNSOED, UNAND, UNMUL and UNDIP.
•
To strengthen collaborative researches on Global Health between Heidelberg
University, Ludwig Maxmillan University, DKFZ, Sanckenberg Museum and InterUniversity Center on Global Health (IUCGH).
•
To transfer, share and disseminate advances in sciences, technology, knowledge and
skills on global health issues.
•
To contribute to the Indonesian policy makers on how to tackle global health issues.
•
To collaborate in getting research funds from international agencies.
•
To promote sustainability through equal partnership.
•
To promote collaboration with other funding agencies and partners, nationally and
internationally
13
B. Roadmap of Inter-University Center on Global
1. Roadmap on climate change and human health
Natural biodiversities
and herbal medicine
a.
Impact climate
change on natural
biodiversity of
herbal medicine
a. Interprofessional
education
a. Behaviour
change
Health
professional
education
Mental
health
Epidemiology and
surveillance for
communicable
diseases
Environmental health
a.
a.
Research on Tropical
diseases (malaria, TB,
dengue)
b. Surveillance system
development
c. Vector control
methods development
a. Research on disaster
mitigation and risk
reduction
b. Impact of the disaster
on tropical diseases
analysis
c. Relieving environment
quality post disaster
d. Man-made disaster
(coal mining,
deforestation)
Disaster
Management
Research on clean
water resources
b. Environmental
pollution
management
c. Impact of
environmental
change on tropical
diseases analysis
Community health
nutrition
a.
b.
Food security analysis
Impact of the
environmental changes
on the status of
community health
nutrition analysis
Climate Change
And Human Health
a. Research on Geographic
Informatics System (GIS)
development
b. Database development of
the impact of climate
change on public health
c. Learning center
development of climate
change and public health
Health Education and
Informatics System
a.
Climate change and
human health research
and development
evaluation
b. Evidence based health
policy on climate change
and public health
c. Policy advocacy to the
local and national
government
Health Policy, Research
and Advocacy
14
2. Roadmap on cancer
Community life
style & nutrition
a.
a. Research on community
life style
b. Research on community
diets and nutritional
status
c. Early detection of
epithelial EBV using CISH
d. Standardized
immunological early
detection of EBV
Infection
Health education and
information center
Health support
system and
insurance
b.
Health care
financing for
cancer
treatment
Health care
delivery
system
(prevention,
promotion,
curative &
rehabilitation)
Epidemiology,
database
a. Epidemiological data on
cancer incidence &
prevalence
b. Research on financing
and losses due to cancer
c. Cancer registry registry
using population based
d. Epidemiological data on
NPC risk & aethiological
a. Learning center on cancer
b. Provision of information about
cancer (book, leaflet and
digital)
c. Evaluation of the level of
public knowledge about the
risk factors for cancer
d. Involved in health education
e.
Health professional
education
a. Integrating cancer management in
undergraduate & post-graduate
programs
b. Standard prognostic markers
improvement.
c.
Cancer, Breast &
NPC
a.
Research on cancerrelated virus
b. Research on the effect
of the virus to the
onset of cancer
a. Research on cancer
genomic & proteonomic
b. identification of genes as
a therapeutic and
diagnostic target in
cancer
c. Making cancer tissue bank
d. Primary cancer cell
culture
Human Genetic
a. Genomic analysis
associated with
susceptibility to cancer
b. Analysis of inheritance
patterns cancer
c. Prognostic factor
Mental health
a.
Research on palliative
care
Reduced Cancer
incidence, early
diagnostic, and
improve treatment
result
Herbal Medicine &
Biodiversity
a. Inventory and
preparation data base on
native medicinal plants in
Indonesia
b. Identification of active
ingredients from
medicinal plants
c. Testing active ingredient
as a potential therapeutic
model for cancer in silico,
in vitro and in vivo
d. Research on the toxicity
of the active ingredients
of medicinal plants
e. Biodiversity medicinal
plants
f. Research on the effect of
free radical detoxication
using tobacco smoke to
the quality of life of
cancer patients
Health policy &
advocacy
a.
Evaluation of the
hospital need for
cancer diagnostic and
therapeutic
b. Evaluation of early
cancer screening policy
c. Evaluation of cancer
funding system
15
C. Program matrix of Inter-Universitiy Center on Global
1. Program matrix on climate change and human health
Program
Activities
a. Research on Tropical diseases (Malaria, TB,
Dengue):
1. Impact of climate change on increasing
risks of tropical diseases
Epidemiology
and surveillance
for
communicable
diseases
b. Surveillance system development
1. Disease integrated surveillance system
1.
2.
3.
4.
5.
6.
Epidemiologist
Statisticians
Entomologist
Health informatics
Clinicians
Computer
programmer
c. Vector control methods development
1. Impact of climate change on vector
bionomics in epidemiological
perspective
2. Impact of climate change on vector’s
dynamic transmission
a. Research on clean water resources
1. Impact of climate change on the variety
of biodiversity
2. Impact of climate change on quality and
quantity of clean water resources
3. Impact of deforestation on clean water
resources
Environmental
health
Expertise
1.
2.
3.
4.
5.
6.
b. Environmental pollution management
1. Carbon footprint measurement
2. Impact of deforestation on carbon
footprint
3. Impact of climate change on the level of
heavy metals in marine environment
c. Impact of environmental change on tropical
diseases analysis
1. Impact of global warming on tropical
7.
8.
Environmental
health specialist
Epidemiologist
Industrial hygiene
Clinicians
Environmental
engineer
Fishery and
oceanography
Biologist
Forestry
Investment
1. Routine
research
funding
2. Competitive
research grants
3. Laboratory
(building and
mobile)
4. Information and
technology
devices
5. Human
resources
6. Overhead
1. Routine
research
funding
2. Competitive
research grants
3. Laboratory
device
4. Human
resources
5. Overhead
1
√
2
√
3
√
4
√
Year
5 6 7
√ √ √
8
√
9
√
10
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
16
diseases
a. Food security analysis
1. Impact of climate change on food
supply in rural area
2. Impact of the global environmental
change on community coping strategy
to maintain food supply
Community
health nutrition
Health Education
and Informatics
System
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
Healthcare
administrator
2. Health promotion
3. Sociologist
4. Civil engineer
5. Environmental
health
6. Maternal child
health
7. Clinicians
8. Pharmacist
9. Nurse
10. Dentist
1. Routine
research
funding
2. Competitive
research grants
3. Mobile health
care service
4. Health care
device for
disaster
5. Human
resources
6. Overhead
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
1. Health informatics
2. Health educator
3. Healthcare
1. Routine
research finding
2. Competitive
√
√
√
√
√
√
√
√
√
√
b. Impact of the global environmental changes
on the status of community health nutrition
analysis
1. Community health nutritional
evaluation and metrics
2. Coping strategy and community
empowerment to deal with global
environmental changes
a. Research on disaster mitigation and risk
reduction
1. Disaster identification and mapping
2. Community awareness on disaster
preparedness and risk reduction
Disaster
1. Routine
research
funding
2. Competitive
research grants
3. Laboratory
device
4. Human
resources
5. Overhead
1. Public health
nutritionist
2. Health evaluator and
metrics
3. Agriculture
4. Veterinary
b. Impact of the disaster on tropical diseases
analysis
1. The design on a prompt treatment for
health care service in the disaster area
2. Health care networks for disaster
response
c. Relieving environment quality in the post
disaster
1. Environmental hygiene relieving in the
disaster area
2. Hygiene and sanitation innovation for
disaster
a. Research on Geographic Informatics System
(GIS) development
1. Mapping for climate change impact on
1.
17
2.
vector transmission
Information and technology designs on
climate change monitoring and
evaluation
administrator
4. Geographer
5. Computer
programmer
b. Database development of the impact of
climate change on public health
1. Database development for research of
the impact climate change on health
Health Policy,
Research and
Advocacy
c. Learning center development of climate
change and public health
1. Joint program for degree and nontraining on climate change and public
health
2. Distance learning center development
for climate change and public health
a. Climate change and human health research
and development evaluation
1. Measuring economic burden of the
impact of climate change on health
2. Model development of the impact of
climate change on health
3. Healthcare financing system
development in response to climate
change
4. Longitudinal study on climate change
and public health
1.
2.
3.
4.
5.
6.
Health policy
Health economics
Statisticians
Political science
Economics
Law
research grants
3. Information and
technology
devices
4. Building
5. Promotion
6. Scholarships
7. Human
resources
8. Overhead
1. Routine
research
funding
2. Competitive
research grants
3. Benchmark
activities
4. Advocacy
activities
5. Human
resources
6. Overhead
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
b. Evidence based health policy on climate
change and public health
1. Systematic review development for
climate change and public health
2. Climate change and public health forum
c. Policy advocacy to the local and national
government
1. Government and community
empowerment to prevent and mitigate
18
2.
Natural
biodiversities and
herbal medicine
Health
professional
education
the impact of climate change on health
Legal action empowerment on the
issues of climate change
a. Impact climate change on natural
biodiversity of herbal medicine
a. Inter-professional education
1.
2.
3.
4.
5.
Public health
Pharmacist
Clinician
Biologist
Forestry
1. Health education
2. Healthcare
administration
1.
2.
Mental health
a. Behaviour change
Public health
Psychology
1. Routine research
funding
2. Competitive
research grants
3. Laboratory
device
4. Human resources
5. Overhead
√
√
√
√
√
√
√
√
√
√
1. Routine research
funding
2. Competitive
research grants
3. Human resources
4. Overhead
√
√
√
√
√
√
√
√
√
√
1. Routine research
funding
2. Competitive
research grants
3. Human resources
4. Overhead
√
√
√
√
√
√
√
√
√
√
19
2. Program matrix on cancer
Program
Activities
a.
Community life
style & nutrition
Research on community life style
1. Identification of smoking, alcohol, herbs
etc.
2. Identification of physical exercise, rest
and work
b. Research on community diets and nutritional
status
1. Identification of nutritional status
(obesitas, overweight etc) in community
c. Research on correlation between hormonal
factor with malignancy
1. Cancer research based on ethnic
a.
Human genetic
b.
Infection
Cancer
Genomic
analysis
associated
with
susceptibility to cancer
1. Identification of genes in the host
associated with the malignancies (BRCA,
Analysis of inheritance patterns of cancer
1. Analysis of inheritance patterns of cancer
a. Research on cancer-related virus
b. Research on the effect of the virus to the onset
of cancer
c. Early detection of epithelial EBV using CISH
d. Standardized immunological early detection of
EBV
a.
Research on cancer genomic & proteonomic
1. Research to determine patomolecular
cancer development (Breast and
Expertise
1. Epidemiologist
2. Statisticians
3. Health
informatics
4. Clinicians
1.
2.
3.
4.
Clinicians
Biomolecular
Bioinformatic
Geneticians
Investment
1. Routine research
funding
2. Competitive
research grants
3. Information and
technology
devices
4. Human resources
5. Overhead
1. Routine research
funding
2. Competitive
research grants
3. Laboratory
device
4. Human
resources
5. Overhead
1. Clinicians
2. Biomolecular
3. Bioinformatic
4. Microbiologist
5. Pathologist
6. Immunologist
1. Routine research
funding
2. Competitive
research grants
3. Laboratory
device
4. Human
resources
5. Overhead
1. Clinician
2. Biomolecular
3. Bioinformatic
1. Routine research
funding
2. Competitive
1
√
2
√
3
√
4
√
Year
5 6 7
√ √ √
8
√
9
√
10
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
20
b.
c.
d.
a.
b.
Epidemiology,
Database
c.
d.
Nasopharynx), i.e. mutation, methylation,
ekspression
2. Research oncogenic viral as the inductor
malignancy
3. Studies evaluating cancer treatment
4. Studies evaluating cancer diagnostic
Identification of genes as a therapeutic and
diagnostic target in cancer
1. Identification of cancer proteins in tissues
and circulation
2. Identification of key genes in cell
proliferation and anti-apoptotic
Making cancer tissue bank
1. Collection and storage of tissues and
clinical data of cancer patients
Primary cancer cell culture
1. The research development of primary cell
cultures for diagnostic and therapeutic
2. Research development of cell lines from
cancerous tissue
Epidemiological data on cancer incidens &
prevalances
1. Ongoing research on the prevalence,
incidence, and new cases of malignant
tumor types based on hospital
Research on financing and losses due to cancer
1. Research to identify costs, duration of
hospitality, life expectancy and mortality
as a basis for evidence based medicine
Cancer registry
1. Compilation of data cancer based
Geographic Information System (GIS)
2. Using population based by collecting and
entering datas from hospitals,
histopathology lab, and other health
centres
Epidemiological data on NPC risk &
aethiological factors
4.
5.
6.
7.
Health statistic
Biologi
Microbiology
Patholog
1. Healthcare
administrator
2. Health
promotion
3. Health
statistician
4. Clinicians
research grants
3. Laboratory
device
4. Human
resources
5. Overhead
1. Routine
research
funding
2. Competitive
research grants
3. Computer
equipment
4. Human
resources
5. Overhead
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
21
a.
Health Education
and Informatics
System
Learning center on cancer
1. Making learning center for cancer as a
center for research and information
b. Provision of information about cancer
(book, leaflet and digital)
c. Evaluation of the level of public knowledge
about
the risk factors for cancer
1. Health
informatics
2. Health educator
3. Healthcare
administrator
4. Computer
programmer
1.
2.
3.
4.
5.
6.
7.
8.
1. Health
Health Policy and
Advocacy
a. Evaluation of the hospital need for cancer
diagnostic and therapeutic
b. Evaluation of early cancer screening policy
c. Evaluation of cancer funding system
a.
Herbal Medicine
and Biodiversity
b.
Inventory and preparation data base on native
medicinal plants in Indonesia
1. Data collection of plants used as medicine
in the community
2. The collection of scientific data on the
potency medicinal plants against
malignancy
Identification of active ingredients from
medicinal plants
1. The identification of the chemical
structure of the active ingredients of
medicinal plants
2. Analysis of the distribution and
composition of active ingredients of a
medicinal plant
informatics
2. Health educator
3. Healthcare
administrator
4. Clinician
1.
2.
3.
4.
5.
Clinician
Pharmacist
Biomolecular
Bioinformatic
Biologi
Routine
research finding
Competitive
research grants
Information and
technology
devices
Building
Promotion
Scholarships
Human
resources
Overhead
1. Routine research
finding
2. Competitive
research grants
3. Information and
technology
devices
4. Building
5. Human
resources
6. Overhead
1. Routine research
funding
2. Competitive
research grants
3. Laboratory device
4. Building
5. Human resources
6. Overhead
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
22
c.
d.
e.
f.
Testing active ingredient as a potential
therapeutic model for cancer in silico, in vitro
and in vivo
1. The research potential of the active
ingredient as an inhibitor of protein in
malignancies using molecular docking
method
2. The research potential of the active
ingredient as an inhibitor of protein in
malignancies using cell line and primary
cell
3. The research potential of the active
ingredient as an inhibitor of protein in
malignancies to human subject
Research on the toxicity of the active
ingredients of medicinal plants
1. Study the toxic effects of an active
ingredient of medicinal plants
Biodiversity medicinal plants
1. Herbal medicine cultivation for drug
development puupose
The new thinking causes of cancer related to
free radical (Research on the effect of free
radical detoxication using tobacco smoke to
the quality of life of cancer patients)
1. Identify cancer caused by free radical
2. Eliminate the rest free radical effect of
cancer therapy
Health support
system and
insurance
a. Health care financing for cancer treatment
b. Health care delivery system (prevention,
Mental health
a. Palliative care
promotion, curative & rehabilitation)
1. Health
economics
2. Health policy
3. Healthcare
administration
4. Public health
1. Psychology
2. Clinician
1. Routine research
funding
2. Competitive
research grants
3. Human resources
4. Overhead
1. Routine research
funding
2. Competitive
research grants
3. Human resources
4. Overhead
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
23
VI.
Stewardship
A.
Collaboration working phase
Phase 1
Building the foundation:
led by the German
partners
2014 - 2017
B.
Phase 2
Internal Consolidation: led
by German and
Indonesian partners
2018 - 2020
Phase 3
Self financing and self
governance: fully led and run
by Indonesian
2020 - 2023
Administrative structure
Phase
1
Germany
- Director of IUCGH
- Group leader of clusters
- Scientists
2
- Vice director of IUCGH
- 50% group leader of clusters
- Scientists
3
- Scientists
-
Indonesia
Vice director of IUCGH
Head of administration
Scientists (professor, PhD senior,
post doc student and PhD student)
Director of IUCGH
Head of administration
50% group leader of clusters
Scientists
Director of IUCGH
Vice director of IUCGH
Head of administration
100% group leader of clusters
Scientists
24
C.
Teamwork for proposal development
1. Indonesian partners
No
1
Name
Dr. Ing. Ir. Agus Maryono
Institution
SEAMOLEC
Phone
+62811254254
Email
[email protected]
2
dr. Titi Savitri P., PhD
Faculty of Medicine-UGM
+6281328780180
[email protected]
3
Prof. Yati Soenarto
Faculty of Medicine-UGM
[email protected]
4
dr. R. Artanto Wahyono, Sp.B
Faculty of Medicine-UGM
[email protected]
5
Budi Aji, M.Sc
+49-17637647427
[email protected]
6
Eri Wahyuningsih, S.Ked, M.Kes
+6283862444165
[email protected]
7
Dwi Sarwani SR, SKM, M.Kes
+6281328581788
[email protected]
8
dr. Wirsma Arif Harahap
Faculty of Medicine and Health
Sciences-UNSOED
Faculty of Medicine and Health
Sciences-UNSOED
Faculty of Medicine and Health
Sciences-UNSOED
Faculty of Medicine-UNAND
+628126630118
[email protected]
9
Ikhwan R. Sudji, M.Si
Faculty of Medicine-UNAND
+49-17636279276
[email protected]
10
11
Ade Rahmat Firdaus, M.Sc
dr Ahmad Zulfa Juniarto, M.Si
Med, SpAnd
dr. Dodik Pramono, M.Si.Med
Faculty of Public Health-UNMUL
Faculty of Medicine-UNDIP
+6281327646478
[email protected]
[email protected]
12
Faculty of Medicine-UNDIP
[email protected]
2. Germany partners
No
1
Name
Prof. Dr.med. Rainer Sauerborn
2
Dr.Joerg Hoheisel
3
Prof. Dr. Michael Wink
4
Prof. Dr. med. Matthias Siebeck
5
Dr. Tobias Schneck
Institution
Institute of Public Health, UniHeidelberg
Deutsches
Krebsforschungszentrums/German
Cancer Research Center (DKFZ),
Heidelberg
Institute of Pharmacy and Molecular
Biotechnology, Uni-Heidelberg
Center of International Health, LMU
München
Senkenberg Museum Geselschaft für
Naturforschung, Frankfurt
Phone
+49-6221565344
+49-6221424680
Email
[email protected]
[email protected]
+49-6221544880
[email protected]
+49-8951602613
[email protected]
[email protected]
+49-6975421514
25
VII.
Closing remarks
IUCGH provides a promising future to tackle climate change and human health and cancer issues
in Indonesia. Through unique collaboration and networks among universities and research
centers in Indonesia, IUCGH will encourage creativity and capability of each element and seize
the resonance of its impacts and benefits toward the development of global health concern in
Indonesia. IUCGH is plausible and potential to be a leading institution which has several
strengths and opportunities:
a. North and South collaboration will create mutual opportunity for knowledge transfer and
scientific development.
b. Sustainable project funding through equal partnership and mutual agreement between
Indonesia and Germany.
c. Leading center of excellence for global health development with university and research
center networks as main input as well as its strength.
d. Partnership and synergy with government policy and programs will assure effectiveness
of its programs and maintain sustainability of the efforts.
IUCGH is initiated with an eagerness of mutual and equal partnership between Indonesia and
German in response to disseminate global concern about public health, climate change, cancer
and biodiversity protection. Governing body of IUCGH should reflect to this initiative and
facilitate transfer of knowledge and skill. At the beginning of this program, German institution
will responsible to the day to day management of IUCGH and Indonesia institution will
participate as supporting partner. In this stage, transfer of knowledge and experience from North
to South is expected to be realized.
In the second phase of the program, will be equal proportion between German and Indonesia
institution. Assistantship and joint working will be carried out in this phase. The process of
transfer knowledge is continuing but the role of Indonesian institution will be more prevalent.
The second stage is a crucial phase where a transition of responsibility will be occurred. Finally,
in the third phase, all governing body and the management of the program become Indonesian
institution responsibility.
26