From Wallace to vaccines: Indonesia seeks homegrown malaria solutions

..natural resources become strategic assets only when they are properly researched, standardized, and developed into products domestically.

Jakarta (ANTARA) - In February 1858, inside a small bamboo hut in Dodinga, Halmahera, British naturalist Alfred Russel Wallace lay ill with malaria.

His body shook with cold chills followed by heavy sweating, keeping him bedridden for days in a village surrounded by low hills.

During breaks between bouts of fever, a groundbreaking idea came to him. He wrote down his thoughts on natural selection and sent the manuscript to Charles Darwin in England.

The historical paper bore a Ternate postmark, leading many to associate the development of the theory of evolution with the famous Spice Island.

However, Wallace's personal field journals, preserved at the Linnean Society of London, tell a different story.

His records indicate that he was ill in Halmahera throughout February and did not return to Ternate until March 1. To treat his fever and help his local assistants, he relied on cinchona bark extract, which contains compounds used to produce quinine.

More than a century later, malaria remained one of the biggest public health challenges facing newly independent Indonesia.

On November 12, 1959, President Soekarno sprayed DDT, a synthetic insecticide, inside a home in Kalasan village, Yogyakarta. The symbolic act marked the launch of a nationwide malaria eradication campaign.

Five years later, approximately 63 million people had been protected from the disease. November 12 subsequently became National Health Day. The mass spraying campaign reached households across Java, Bali, and Lampung.

Eastern Indonesia, however, faced a much longer battle. By 2026, approximately 80 percent of Indonesia's districts and cities had achieved malaria-free status, while 95 percent of the country's remaining cases were concentrated in Papua.

Throughout 2025, the Health Ministry recorded 706,297 malaria cases. The high figure came amid more active case detection by health workers, supported by improvements in digital reporting systems.

The disease that troubled Wallace in Halmahera continues to affect communities in eastern Indonesia. Now, the government is pursuing a new approach: developing a domestically produced malaria vaccine.

Following a cabinet meeting at the Presidential Palace on October 27, National Research and Innovation Agency (BRIN) Head Arif Satria said President Prabowo Subianto had asked about progress in malaria vaccine development and called for research to be accelerated.

BRIN, working with the Health Ministry and state-owned pharmaceutical and vaccine manufacturer Bio Farma, aims to shorten the development timeline by three years.

The vivax gap

Globally, two malaria vaccines have received World Health Organization recommendations: RTS,S and R21.

Both target Plasmodium falciparum, the parasite responsible for the deadliest form of malaria and particularly prevalent in Africa.

However, neither vaccine targets Plasmodium vivax, which causes a substantial share of malaria cases in Southeast Asia.

Arif noted that malaria parasites circulating in Indonesia have distinctive characteristics and that no approved vaccine is currently available against P. vivax. For this reason, Indonesia has an opportunity to make a significant contribution to global health research.

In Papua region, the gap in protection is particularly pressing.

A study conducted in Timika between 2004 and 2005 found that 37 percent of confirmed malaria cases were caused by P. vivax. Among infants under one year old, the parasite was the leading cause of infection.

Chloroquine-resistant P. vivax was first identified in Papua in 1989. The region has since been reported to have some of the world's highest rates of drug-resistant P. vivax.

Subsequent research at a hospital in Timika linked multidrug-resistant P. vivax infections to severe malaria and deaths, particularly among young children.

For decades, P. vivax was widely regarded as a milder form of malaria. Findings from Papua have demonstrated that the disease can also cause serious illness and death.

A domestically developed P. vivax vaccine would therefore address an important gap in global malaria research. It would target a neglected area of vaccine development using scientific knowledge and research material available in Indonesia.

Scientific breakthroughs often emerge from close engagement with local challenges, and few countries have as much direct experience with drug-resistant P. vivax as Indonesia.

The vaccine initiative would also support the Health Ministry's broader strategy of testing, treating patients, and controlling mosquito populations as the country works toward malaria elimination by 2030.

The most advanced vaccine candidate has entered the preclinical stage, while other candidates remain at the conceptual stage.

Achieving the target three years ahead of schedule will require swift action. Clinical trials, reviews by the Indonesian Food and Drug Authority (BPOM), and preparations for production at Bio Farma must be planned alongside laboratory research.

Cinchona-based medicine

Indonesia was once a leading global producer of plant-based malaria medicine.

The cinchona tree, native to the Andes Mountains in South America, was introduced to Java in the 19th century, where it was cultivated for quinine production.

On June 29, 1896, the Bandung Cinchona Factory opened in West Java. By 1942, it had become the world's largest cinchona processing facility.

When Java fell under Japanese occupation during World War II, Allied forces fighting in the Pacific lost access to one of their main sources of cinchona.

In Papua, military operations around Milne Bay in late 1942 were reportedly delayed because troops lacked adequate antimalarial medicines and preventive measures.

This history offers an important lesson: natural resources become strategic assets only when they are properly researched, standardized, and developed into products domestically.

According to BPOM, Indonesia has approximately 30,000 plant species with medicinal potential. Around 18,000 are used in traditional herbal medicine, or jamu. However, only 71 have been developed into standardized herbal medicines, while just 20 are classified as phytopharmaceuticals—natural medicines that have undergone human clinical trials.

The 19 phytopharmaceutical candidates mentioned by Arif are therefore significant. If all successfully complete the necessary assessments, they could nearly double the country's existing number of phytopharmaceutical products.

Currently, these candidates are classified as standardized herbal medicines while undergoing clinical trials.

BRIN has also recently partnered with South Korea's National Institute of Food and Drug Safety (NIFDS).

The partnership focuses on standardizing herbal products and researching compounds derived from medicinal plants. Inadequate standardization has long limited the ability of traditional herbal remedies to expand beyond basic markets.

The stakes extend beyond the pharmaceutical industry. In July, House of Representatives Commission VI Chairperson Anggia Erma Rini noted that Indonesia still imports approximately 95 percent of its pharmaceutical raw materials, primarily from China and India.

Phytopharmaceuticals offer a potential alternative because their raw materials can be cultivated domestically.

The malaria vaccine and phytopharmaceutical development share a common objective: building on Indonesia's distinctive strengths, from a malaria parasite that remains inadequately addressed by existing vaccines to medicinal plants that still require extensive domestic research and testing.

Arif said President Prabowo wanted Indonesia to achieve pharmaceutical self-reliance in the near future. He argued that this was a realistic goal because the country did not necessarily need to compete directly in markets dominated by global pharmaceutical giants. Instead, Indonesia could focus on developing products based on resources and research capabilities available at home.

Cinchona demonstrated this potential more than a century ago, although Indonesia did not retain all the economic benefits of its production. The next challenge is to strengthen downstream development and market access.

The Phytopharmaceutical Formulary, launched by the Health Ministry in 2022, paved the way for these herbal medicines to be used in healthcare facilities, supported by the Special Allocation Fund and the National Health Insurance (JKN) system.

The Indonesian Association of Medical Herbal Doctors has called for phytopharmaceuticals to be included in the National Formulary, allowing doctors to prescribe them more easily under the JKN system.

Medicines that have successfully passed clinical trials still need a market. The national health insurance system, with its extensive coverage, could provide a significant source of demand.

The same principle applies to vaccines. Securing a place in the national immunization program would help Bio Farma scale up production once a vaccine has completed the necessary development and approval processes.

One hundred and sixty-eight years after Wallace shivered with fever in Dodinga, Halmahera, malaria continues to affect communities in eastern Indonesia, particularly Papua. The country is now seeking solutions through its own research laboratories.

On November 12, Indonesia will commemorate National Health Day, a date rooted in the country's historic campaign against malaria.

The battle continues in eastern Indonesia. This time, the country hopes to develop more of the solutions at home.

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