AUDIE CORNISH, HOST:
Indonesia surpassed a million cases of COVID-19 this week. More than 28,000 people have died. And while experts say many more deaths have likely gone unreported, that toll is higher than any other country in Southeast Asia. Now, the country has begun its vaccination program, but not everyone is happy with its approach. Michael Sullivan reports.
MICHAEL SULLIVAN, BYLINE: Frontline health workers? Check. The president and other important officials? Check. Social media influencers? Check. The most vulnerable group, older people? No. They'll have to wait for the second round of vaccinations later this year.
PANDU RIONO: The drive is economy, not the pandemic or not to reduce the death of the people.
SULLIVAN: University of Indonesia epidemiologist Pandu Riono says the government is focused on jumpstarting an economy in recession for the first time in more than two decades, which helps explain its decision to prioritize vaccinations for those between 18 and 59.
RIONO: People who will contribute to economic recovery. They believe the young people is more productive and can make the economy recovery faster.
SULLIVAN: Indonesia's new health minister admits the economy is a driver but says this strategy is also to protect people from COVID by targeting those most likely to get it and spread it, including to older family members. But there's also a very pragmatic reason older people aren't getting the Chinese Sinovac vaccine.
MUHAMMAD HABIB ABIYAN DZAKWAN: We did the clinical trial testing for the vaccination. However, we did not involve elderly above 59. So we are not pretty sure about the safety of this vaccine to this group.
SULLIVAN: Muhammad Habib is a researcher at Jakarta's Center for Strategic and International Studies. Like the epidemiologist, Pandu, he says economic concerns have always driven Indonesia's COVID response and are partly responsible for the country's low testing and tracing rates and its focus on a vaccine over better enforcement of health protocols. Not surprisingly, Indonesia is now recording some of its highest daily totals since the pandemic began.
IRMA HIDAYANA: The line for entering the emergency rooms in Jakarta and surrounding areas, it's long.
SULLIVAN: Irma Hidayana is co-founder of Lapor COVID-19, an online platform that collects and analyzes COVID-related data.
HIDAYANA: Maybe it will take a couple or three hours for people to get in. That is one of the signs that hospitals and health system is collapsing right now.
SULLIVAN: A few weeks ago, she tried to find a bed for a seriously ill patient who spent two days in a village primary care facility while waiting to be transferred to the capital.
HIDAYANA: We blast a message to 49 hospital contacts in Jakarta. They are full. They are all full. And then I reach out the assistance of health minister, and then they couldn't help either. The person died at the primary health care.
SULLIVAN: She expects things to get worse as more facilities are overwhelmed. Indonesia plans to immunize roughly 180 million people, an ambitious target in a country of more than 14,000 islands spread across a vast and hot archipelago, one where proper storage of the refrigerated vaccines is a challenge. And so is the efficacy of the Sinovac vaccine, which has turned out different rates in different studies in different countries, raising questions about the vaccine's overall effectiveness. For NPR News, I'm Michael Sullivan in Chiang Rai, Thailand.
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