Superbugs & Super Chill: How Indonesia Slept Through an Antibiotic Crisis

When it comes to Healthcare in Indonesia, I have always been an advocate for two issues: stunting & antibiotic resistance.

My friend, a microbiologist, recently attended a conference in Europe. He told me that Indonesia tops the charts for antibiotic resistance in the world.

Our government, until very recently, had barely blinked. They’ve apparently appointed a group to lead deeper studies, as though this crisis were new.

I’ve long been warning against antibiotic overuse when it comes to self-medication, including livestock misuse.

I refuse to take any antibiotic for my illness/infection unless it’s for a really bad infection, and I don't mean a really bad sore throat.

The last time I had antibiotics was in 2022 when I threw a house party for my birthday and somehow I ended up with Typhus fever, while the rest of my friends contracted covid. I'd gladly choose Covid.

You might think this is a hyperbole, but recent (and old) studies confirm what many of us have been seeing in clinics, pharmacies, and families.

The question is: how bad is it, how did we let it get this bad, and what do we do now?

The Situation

It’s bad. Far worse than what most people know, and to be honest, I don’t blame the general public for not knowing anything about antibiotic resistance.

The government is not even aware of it, and if you search on Youtube or Google regarding antibiotic resistance in Indonesia, a list of boring webinars and scientific journals come up, which nobody with a sane mind would want to watch or read. So yes, everyone is oblivious to this crisis.

I'm not talking about a hypothetical future where medicine stops working, I'm saying we’re already here.

A 2025 meta-analysis across Indonesian hospitals and communities found that almost half of bacterial infections tested are resistant to standard antibiotics. Half. Think about that.

The culprits are depressingly familiar: E. coli, Klebsiella pneumoniae, Acinetobacter, Pseudomonas the same bacteria that cause the fevers, wounds, and pneumonias people still assume can be “easily treated.”

Except they can’t, not anymore.

In hospitals, doctors are quietly running out of options. Drugs that used to work, amoxicillin, ceftriaxone, ciprofloxacin, are failing at alarming rates. What should be routine infections now require stronger, riskier, and much more expensive medications, if any still work at all.

For some patients, the best that modern medicine can offer is hope that this antibiotic might still hit the target. Meanwhile, families spend days, sometimes weeks, watching someone they love not getting better from what used to be a trivial illness.

It doesn’t stop in hospitals. It is systemic.  The “One Health” study from 2025 confirmed what microbiologists have been whispering for years: resistance genes are now part of our environment. They’re in livestock, wastewater, soil, even in the food we eat. When farmers feed antibiotics to chickens or fish to “prevent sickness,” they’re not just keeping the animals healthy, they’re breeding superbugs that end up in our rivers and dinner plates. You could live far from a hospital and still carry antibiotic-resistant bacteria without ever realizing it. That’s how deep this goes.

I would give you numbers, but I’m afraid they’re not publicly available. There aren’t any that show, in clear terms, how far we’ve actually come in tackling this problem.

However, I did find a government statement that sheds some light on what’s being done.

In September 2024, the Indonesian government released the results of its monitoring and evaluation for the National Action Plan for Antimicrobial Resistance Control (RAN PRA 2020–2024),  a program coordinated by the Ministry of Human Development and Cultural Affairs, in collaboration with the FAO and the European Union, under the One Health framework. According to the report, most of the program’s performance targets have been met, showing what officials described as “significant and sustained effort” across human, animal, and environmental health sectors.

On the agricultural side, the government highlighted the ban on Antibiotic Growth Promoters (AGPs) and colistin in commercial poultry farms, policies that, according to field data, have begun to lower resistance rates and reduce the presence of ESBL-producing bacteria. The Ministry of Agriculture credited better awareness among producers, reduced preventive antibiotic use, and stronger biosecurity practices for this progress.

In human health, however, the tone was more cautious. The Ministry of Health admitted that rational antibiotic use and ESBL control in hospitals have not yet met national goals. In response, a new National AMR Control Strategy was launched to guide the next phase of cross-sectoral action, focusing on better surveillance, stricter prescription monitoring, and regional enforcement.

Both the FAO and WHO praised Indonesia’s progress and reiterated support, calling the country’s approach “a model of collaborative commitment.” The government, for its part, pledged to strengthen AMR data sharing (WHERE?), expand control programs beyond Jakarta and major cities, and integrate AMR governance into the broader national development plan.

In other words, Indonesia isn’t doing nothing, but as we all can expect, it’s just doing what it can within a system that moves slower than the bacteria it’s trying to control.

They should really trademark “Indonesian Bureaucracy” as our national tourism slogan.

The system have also streamlined prescription drugs TOO efficiently. If you are a user of Tokopedia, you can easily “chat” an online doctor for free and get prescription medication easily, no questions asked. In a matter of minutes, you’ll get a digital prescription from an unknown doctor validating your drug purchase.

Is it a wonderful system? Yes it is.

Do I use it myself? Absolutely.

Who is to blame? Us.

Everytime we feel sick, we self medicate. Which can be a good thing for those with a good sense of general medicine.

For decades, in Indonesia, they have handed out antibiotics like candy, for coughs, for colds, “just in case.” Pharmacies sell them freely, doctors prescribe them to keep patients happy, people keep leftover pills “for next time.”

It’s cultural, even habitual, a symptom of a country that’s learned to self-medicate its way through every fever.

Add to that weak surveillance, sloppy enforcement, and a health system built more on improvisation than infrastructure, and you have the perfect storm.

By the WHO’s projections, Indonesia is on track to be one of the top five countries in the world for antibiotic consumption growth by 2030. That’s not a badge of modern healthcare, it’s a warning sign that we’re running out of weapons faster than we’re creating new ones.

The scary part is that this doesn’t make headlines. It’s boring. There are no burning buildings, and people shouting, and those are bad for ratings.

There’s no public panic, no national debate. Just silent hospitals, long recoveries, and the quiet erosion of trust in medicine.

This isn’t the beginning of a crisis, we’re in the middle of one. And like most things in Indonesia, we’ll probably wait until it’s unbearable before calling it urgent.

I don’t write this to provoke fear, I write this because I can and I want to. This crisis has been visible to those of on the front lines, microbiologists, doctors (good ones), communities, but not always visible to those who write policy.

Yes, the damage is already underway. Can I say it is irreversible? Perhaps, but I have doubts in this country.

If we act with urgency, with honesty, grounded in evidence, we might still bend the curve. If not, generations (our children) will face infections we once considered trivial as death sentences.

The moment to act was years ago. The second moment is now.