Resilience in Action
USAID’s Global Accelerator to End TB boosts Indonesia’s COVID-19 response
Anna Livianika found her true calling after a bit of trial and error. After exploring business and then marketing, she chose a career in the medical field. “Becoming a lab analyst, however, wasn’t part of the plan,” she said — let alone in the midst of an unprecedented global health crisis.
“Before the pandemic, I was planning to continue my studies,” Anna explained. “But COVID-19 changed that. So, I challenged myself: Why not help fight COVID-19?”
Through a volunteer program, Anna was assigned to Wisma Atlet, Athlete’s Village, a makeshift COVID-19 referral hospital in Indonesia’s densely populated capital city, Jakarta. Wisma Atlet was originally constructed to house 20,000 athletes during the 2018 Asian Games. Earlier this year, Jakarta emerged as a COVID-19 hot spot. The city needed to mobilize, and part of that included converting Wisma Atlet into a hospital and outfitting it with the right equipment and staff, including Anna.
“My parents called me on my first day of work and actually asked whether I would just come home,” Anna said. “But I convinced them not to worry.”
Siti Nur Imanta became Anna’s supervisor and the lab coordinator. Siti knew the task ahead was immense given that Indonesia’s testing rate was among the world’s lowest.
“Everything was an emergency,” Siti said. “My family and colleagues were torn when they heard I was going. But I had to know what was going on, despite all of the uncertainties. There wasn’t even a diagnostic lab.”
An old warehouse at Wisma Atlet was quickly converted into a lab and equipped with GeneXperts, rapid TB and HIV diagnosis machines produced by U.S. company Cepheid, Inc. and purchased by the Government of Indonesia to fight its battle against tuberculosis (TB).
With over 845,000 new cases a year, Indonesia bears the world’s third-largest TB burden. In 2013, USAID introduced Indonesia to the GeneXpert technology, which can diagnose drug-resistant tuberculosis in hours instead of weeks. In the following years, the country purchased additional GeneXpert machines to greatly expand access to efficient TB and HIV testing. USAID’s support for increased TB diagnosis, testing, and treatment built a solid foundation of ability and equipment that is now supporting a strong COVID-19 response.
As the dire realities of COVID-19 became clear, USAID coordinated with the Ministry of Health to explore recalibrating GeneXperts to test for COVID-19 (without compromising their continued use for TB and HIV).
“I used to operate GeneXpert for TB diagnosis,” Anna said. “The technical principles of testing for TB and COVID-19 on GeneXpert are similar.”
Recalibrated, the GeneXpert tests for COVID-19 can detect the virus from a swab specimen, meaning that blood does not need to be drawn. Wisma Atlet’s recalibrated GeneXpert machine can run 160 COVID-19 tests each day.
“The GeneXpert test is faster. Within just an hour, we know the results. [Other tests] take four hours,” Siti said.
As part of prior TB support to Indonesia through the Global Accelerator to End TB, USAID worked with local partners to develop and implement the Sistem Informasi TB, or SITB, software application. SITB helps labs, hospitals, and health offices using GeneXpert to complete their reporting requirements to the national TB elimination program.
This year, USAID helped train lab workers like Anna to use the software application to also report COVID-19 results.
Indonesia has recalibrated more than 140 GeneXpert machines and trained over 400 health workers to test for COVID-19 and report through SITB. As of August, over 47,000 samples have been tested, but the government is also using its other networks to conduct testing. Because Indonesia has invested so heavily in GeneXpert, it is able to use these 140 machines without imperiling access to TB testing with the other machines, which remains so critical.
Siti and Anna remain committed to fighting COVID-19. “I hope the COVID-19 pandemic will be over soon so that we can all really enjoy our lives again,” said Siti.
Over the past 20 years, USAID has invested over $1 billion into Indonesia’s health sector, building a strong foundation for a more effective COVID-19 response and directly benefiting over 700,000 patients suffering from TB.
Through the Global Accelerator to End TB, USAID leads the U.S. Government’s global TB efforts, working with agencies and partners around the world to reach every person with TB, cure those in need of treatment, and prevent the spread of new infections.
The United States continues to lead the global effort to respond to and end the COVID-19 pandemic. Since the outbreak of COVID-19, the U.S. Government has announced more than $1.6 billion in State Department and USAID emergency assistance to help fight the pandemic.
About the Author
Samantha Martin is the Development Outreach and Information Editor for USAID’s Mission in Indonesia.
