Locations
The city of Denpasar, Bali, is undergoing a remarkable transformation in a bid to strengthen Indonesia's health infrastructure. Known for its vibrant culture and bustling tourism, Denpasar is now emerging as a beacon of health resilience and innovation. This transformation is being driven by the United Nations Development Programme (UNDP) in collaboration with the Government of Indonesia, with significant support from The Global Fund and GAVI, The Vaccine Alliance. Together, they are spearheading initiatives that are revolutionizing the health landscape in Indonesia through the Health Governance Initiative (HEART) Project.
On 11 February 2024, UNDP Deputy Resident Representative (DRR), Sujala Pant, led a strategic monitoring visit to key health facilities in Denpasar, reinforcing UNDP's commitment to strengthening public health governance. As part of UNDP's Risk, Resilience and Governance portfolio, the visit evaluated crucial health interventions shaping Indonesia's public health preparedness. Engaging directly with healthcare workers and beneficiaries, the mission assessed the impact of digital innovations, disease surveillance strategies, and genome sequencing technology utilization. Alongside the Ministry of Health of the Republic of Indonesia and the Denpasar City Health Office, DRR Pant visited three beneficiary locations such as Puskesmas Denpasar Selatan I, RSUP Prof. Dr. I.G.N.G. Ngoerah, and Faculty of Medicine, Udayana University.
A Commitment to Health & Digital Transformation
The first stop of the visit was Puskesmas Denpasar Selatan. The community health center was among the 12,000 healthcare facilities in Indonesia utilizing the SMILE application, a project under UNDP's HEART initiative. Funded by The Access and Delivery Partnership (ADP), GAVI, the Vaccine Alliance and The Global Fund, SMILE is a digital marvel that enables real-time tracking of vaccines and medications for HIV/AIDS, Tuberculosis, and Malaria (ATM). Since its implementation, SMILE has supported the distribution of over 900 million vaccine doses nationwide, including 3.5 million routine immunization vaccines and 74,000 anti-rabies vaccines in Bali alone. Due to its impact on tourism, rabies remains a critical public health concern in Bali.
"Rabies is a highly sensitive issue for tourism in Bali. This application accelerates response efforts while providing assurance regarding program readiness and human resource capacity to manage rabies cases," said I Wayan Pujana, Epidemiologist at the Bali Provincial Health Office.
Before the adoption of SMILE, monitoring rabies vaccine stocks required manual coordination with district health offices, causing delays in response efforts. "Now, we can record real-time stock levels across all district and city health centers, underscoring how the system ensures timely vaccine availability and enhances logistical efficiency,” said Pujana.
Deputy Resident Representative Sujala Pant gains hands-on experience with the SMILE app to monitor vaccine stock management at Puskesmas Denpasar Selatan I
As of December 2024, SMILE actively monitors approximately 129 million ATM program medications, ensuring supply chain transparency and efficiency. Recognized through the Minister of Health Decree in 2024, SMILE is now an integral part of Indonesia’s national health logistics system and fully integrated with the Ministry of Health’s SATUSEHAT platform.
During her visit to Puskesmas Denpasar Selatan I, DRR Pant commended the digital innovation in health services and its role in strengthening governance and disease response.
"SMILE has been an extraordinary system from the outset and remains highly applicable to priority healthcare programs, particularly in facilitating free health screenings, which require both materials and commodities to be effective," she said.
These advancements underscore the significance of digital solutions in enhancing Indonesia’s healthcare infrastructure, ensuring that essential medical supplies reach those in need more efficiently and reliably.
Advancing Sustainable Medical Waste Management and Whole Genome Sequencing (WGS)
At RSUP Prof. Dr. I.G.N.G. Ngoerah, two key advancements are shaping the future of Indonesia’s healthcare system: sustainable medical waste management and whole genome sequencing (WGS) for public health preparedness. The hospital received an autoclave grant from The Global Fund, enhancing its capacity for sustainable medical waste processing with pressurized steam, ensuring compliance with Indonesia’s environmental regulations. Since 2021, UNDP has supported the Ministry of Health in procuring, installing, and training for autoclave operations. To boost efficiency, the hospital integrated ME-SMILE, a digital platform launched in 2023 for real-time tracking and responsible disposal of medical waste. ME-SMILE, adopted by 50 major hospitals across Indonesia, has processed over 50,000 tons of medical waste, transforming healthcare waste governance for safer and more sustainable management.
The visit also highlighted the pioneering work in WGS, conducted through UNDP’s partnership with the Ministry of Health under the Biomedical and Genome Science Initiative (BGSi). This initiative is revolutionizing precision medicine and disease surveillance, equipping Indonesia with cutting-edge genomic capabilities.
As part of BGSi, RSUP Prof. Dr. I.G.N.G. Ngoerah serves as one of nine specialized hubs, focusing on aging, wellness, and nutrition. A network of 10 state-of-the-art WGS laboratories has been established, capable of processing over 10,000 genomic samples annually. An extended network of 29 laboratories further strengthens Indonesia’s health security by integrating genomic sequencing into national surveillance systems, enabling early detection of pathogen mutations and genetic variations.
Autoclave machine at RSUP Prof. Ngoerah, supported by UNDP and WHO through the C19RM grant
Overcoming Challenges through Collaborative Approach
Despite significant progress, one key challenge identified during the visit is the difficulty in obtaining samples for genomic sequencing. Logistical and technical barriers in sample collection, transportation, and processing hinder the timely integration of genomic data into health surveillance. Given the time-sensitive nature of pathogen tracking, addressing these bottlenecks is essential for ensuring Indonesia’s readiness to detect and respond to emerging health threats, including potential pandemics.
Recognizing the critical role of Whole Genome Sequencing (WGS) in disease surveillance, RSUP Prof. Dr. I.G.N.G. Ngoerah has partnered with Udayana University’s Faculty of Medicine. This collaboration allows WGS to be conducted at the university, expanding research and diagnostic capabilities.
WGS is a vital tool in public health, enabling the rapid identification of pathogens responsible for respiratory infections such as influenza and COVID-19. By analyzing the genetic makeup of viruses and bacteria, WGS helps detect mutations, track disease transmission patterns, and inform targeted interventions. The integration of this technology at Udayana University not only enhances Indonesia’s ability to respond swiftly to emerging health threats but also contributes to long-term public health resilience.
Further, the partnership fosters academic and research synergies, providing medical students and researchers with access to cutting-edge genomic technology. This ensures a pipeline of skilled professionals equipped to harness WGS for infectious disease control, precision medicine, and epidemiological studies, ultimately strengthening Indonesia’s healthcare infrastructure.
A vision for future
The visit highlighted the transformative role of technology and data-driven solutions in healthcare. From optimizing logistics with SMILE to improving waste management through ME-SMILE and autoclave technology, and advancing disease surveillance and pandemic preparedness with WGS, these innovations are driving efficiency, resilience, and evidence-based decision-making.
These initiatives align with the Government of Indonesia’s Asta Cita vision for Indonesia Emas 2045, focusing on public well-being and human capital investment. Through continued collaboration between UNDP and the Ministry of Health, these efforts pave the way for a stronger, more inclusive, and sustainable healthcare system, reinforcing national health resilience for the years ahead.
Written by: Maya Tamara