JURNALNEWS.CO.ID – Migration caused by climate change poses direct and indirect threats to public health, by removing affected communities’ access to essential health services. Pharmaceutical companies, as providers of lifesaving medicines and vaccines, must play a vital role in addressing this crisis and strengthening global health resilience. Every year, approximately 2.5 million people worldwide are forced to flee due to natural disasters such as floods, droughts, wildfires, and storms. This number is expected to rise sharply over the coming decades, with projections indicating 1.2 billion people will lose their homes by 2050. The climate crisis is not just a humanitarian disaster but also a global health emergency.

Climate-induced displacement creates various direct and indirect threats to public health. In Indonesia, these impacts are very noticeable, especially in coastal areas and disaster-prone zones. Floods in Jakarta and Semarang, for example, have caused thousands to lose access to basic health services. In Kalimantan and Sumatra, forest fires caused by El Niño in 2015 and 2019 worsened air quality, resulting in over 900,000 cases of acute respiratory infections (ARI).

Furthermore, displacement worsens poverty, population density, and social instability. When food production is disrupted by drought and extreme weather, access to adequate nutrition becomes more difficult. Communities living in refugee camps often face poor sanitation conditions, which accelerates the spread of infectious diseases such as diarrhea, leptospirosis, and cholera. Globally, high-income countries are also not immune to these effects. In the United States, 3.2 million adults were displaced due to natural disasters in 2022. Similar phenomena also occur in Indonesia, where over 2 million people are affected by floods annually.

The pharmaceutical industry has a crucial role in strengthening global health resilience, including in Indonesia. However, so far, no comprehensive strategy exists to ensure that communities affected by climate change have sustainable access to healthcare products. Some companies like Novartis and Novo Nordisk have launched assistance programs for populations impacted by extreme weather, while others donate funds or medical supplies during emergencies. Hikma, a Jordan-based generic drug manufacturer, for example, reported a donation of $4 million in 2020, increasing to $4.9 million in 2023. Yet, these efforts are still far from sufficient. Pharmaceutical companies need to adopt a four-pronged strategy to strengthen health systems amid the climate crisis.

Enhancing Medicine Distribution to Vulnerable Communities. Pharmaceutical companies must adapt their supply chains to be more resilient against disruptions caused by natural disasters. In Indonesia, events such as the Central Sulawesi earthquake in 2018 and Sunda Strait tsunami in 2018 demonstrate how fragile medicine distribution to affected regions can be. Possible solutions include designing more climate-stable products for hot conditions and mass distribution of generic medicines to handle outbreaks in refugee areas.

Investing in Research and Development (R&D). Rising global temperatures accelerate the spread of infectious diseases like dengue, malaria, and Zika, as well as waterborne diseases such as cholera and shigella. Despite the urgent need for innovation, the 2024 Access to Medicine Index shows that pipelines for tropical diseases and new pathogens are shrinking. The lack of antibiotics research worsens the threat of antimicrobial resistance, compounded by poor sanitation conditions caused by climate change.

Building Long-term Partnerships with Humanitarian Organizations. Collaboration between pharmaceutical companies and humanitarian agencies has proven effective in increasing health resilience. Since 2010, firms like GSK and Pfizer have partnered with Gavi, the Vaccine Alliance, to provide billions of vaccine doses to low-income countries.

In Indonesia, similar approaches can be applied through cooperation with agencies such as the National Disaster Management Agency (BNPB) and the Ministry of Health to support vaccine and medicine distribution to disaster-prone areas.

Reducing Greenhouse Gas Emissions in Supply Chains. The pharmaceutical industry is often overlooked in discussions about carbon emissions, yet this sector produces more CO₂ per $1 million revenue than the automotive industry. Pharma companies should adopt greener manufacturing practices, such as using renewable energy in production and optimizing supply chain efficiency to reduce their carbon footprint.

Policy Implications

Indonesia faces major challenges in addressing health impacts from climate change and population displacement. Therefore, comprehensive policies that consider health and climate resilience are essential.

Integrating Climate Adaptation and Health Policies. The government must incorporate health strategies into climate adaptation policies, such as including health indicators in the National Climate Change Adaptation Action Plan (RAN-API) and strengthening food security programs to ensure adequate nutrition for affected communities.

Enhancing Healthcare Infrastructure in Disaster-prone Areas. Building hospitals and emergency clinics in flood, earthquake, and wildfire zones should be prioritized. Telemedicine technology can also help reach isolated populations affected by disasters.

Regulating the Pharmaceutical Industry to Support Health Resilience. The government should incentivize pharmaceutical companies investing in heat-resistant medicines and tropical disease vaccines. Stricter carbon emission regulations for the sector should also be implemented to reduce the health impacts of climate change.

Strengthening the Health System to Respond to Climate Crises. The government needs to improve coordination among the Ministry of Health, BNPB, and humanitarian organizations in disaster response and displacement management. Community-based health programs involving local health centers and healthcare workers can ensure more equitable access to health services.

Indonesia can adopt fiscal policies promoting health resilience, such as subsidies for companies developing medicines and vaccines for disaster-affected regions. The private sector also needs to be involved in climate adaptation initiatives through more structured corporate social responsibility (CSR) programs. Although explicit subsidies for pharmaceutical companies in disaster zones are limited, some indirect support exists, such as tax exemptions and import duty waivers on medicines and health equipment. During emergencies like COVID-19, Indonesia waived VAT on vaccines and certain medical devices.

BNPB also maintains a Ready-to-Use Fund, often used for procuring medicines and health supplies during emergencies. While not directly allocated to pharmaceutical firms, this fund can support local manufacturers in disaster response efforts. Several Indonesian pharmaceutical companies like Bio Farma, Kimia Farma, and Kalbe Farma participate in CSR programs aiding disaster-affected communities. The government offers tax incentives for companies involved in disaster relief.

However, to date, no specific subsidy scheme exists for pharmaceutical companies to produce or distribute medicines exclusively in disaster areas. If such policies are introduced, subsidies could take the form of additional tax incentives, funding for research on disaster-specific medicines, or public-private partnerships supporting health resilience in vulnerable regions.

Migration due to climate change is no longer a future threat but an ongoing health crisis. Indonesia, being highly vulnerable to climate disasters, must adopt a more holistic approach to managing health impacts. Involving the pharmaceutical industry, strengthening healthcare infrastructure, and implementing climate-oriented policies can improve community health resilience amid increasingly extreme environmental changes.

Dr. Aswin Rivai, SE., MM
Economist and Lecturer
Department of Economics, Universitas Pembangunan Nasional Veteran, Jakarta