DALAM PERSPECTIVE PERTAHANAN BIOCRIME BIOTERRORISME BIOLOGICAL WARFARE

GLOBAL HEALTH SECURITY

  DALAM PERSPECTIVE PERTAHANAN BIOCRIME BIOTERRORISME & BIOLOGICAL WARFARE MAYJEN TNI dr. BEN YURA RIMBA, MARS Jakarta 3 Juli 1961.

  Dik: S1, Wamil 87/88, S2, Seskoad, S3 Penugasan: Kostrad, Dam Jaya, Kopassus, Pusdikkes, Unhan, Ditkesad, Puskes TNI Ops: Timor, Irja, Aceh, Bosnia.

  Tugas luar: Afrika Selatan, Amerika, Arab Saudi, Australia, Belanda, Belgia, Brunei, Canada , Cheko, China, Croatia, France, German , Hongaria, India, Japan, Korea, Laos, Malaysia, Mexico, Mesir,Nepal, Philipine, Rusia, Singapore, Serbia,

  Hakekat Ancaman

• Buku Putih Pertahanan 2016
• Ancaman Belum Nyata
• – Perang terbuka
• – Invasi Pasukan Asing
• Ancaman Nyata
• – Terorisme>– Bencana >– Wabah Penyakit>– Narkoba – Pencurian
• – Cyber warfare

Perang Generasi ke 4

• Bentuknya – Proxy War – Assymetric Warfare/ Irregular Warfare • Sasaran – Manusia, Sistem Pemikiran, Sistem Budaya – Sistem komunikasi, system informasi,
• – Sumber Daya Alam di Darat dan Laut – Energi, Air dan Makanan – Industri Kesehatan Manusia, Peternakan dan Pertanian.
• Metodenya menguasai tanpa menghancurkan via
• – Cultural Warfare, Psychological Warfare – Economic Warfare, Currency Warfare,
• – Information Warfare, Cyber Warfare,
• – CBRN Warfare,

  

Mekanisme Pertahanan

Non Konvensional/Nir Militer

• Energy, Water and Food Security • Maritime Security • Cyber Security • CBRN
• – Chemical weapon conv,
• – Bioweapon Conv, – Nuclear anti proliferation.
• Khusus untuk Bioweapon, GHSA
• CHEMICAL – Harrasing Agent.

• – Incapaciting Agents – Lethal Agents:
• BLISTER /NERVES/BLOODS /CHOOKINGS
• RADIOLOGICAL
• – DIRTY BOMB
• NUCLEAR
• – A BOMB , H BOMB/ THERMONUCLEAR, NEUTRON BOMB
• – SALTED BOMB
• BIOLOGICAL

• – BIOLOGICAL ARMED RACE/BIOWEAPOND/BIODEFENSE

  Ancaman Biologi

• Bioweapon
• – Biocrime – Biological Warfare – Bioterrorism
• Mengapa?
• – Mudah dibuat, dibawa dan bereplikasi
• – Dampak Biologis – Dampak Ekonomi – Dampak Sosial – Dampak Pertahanan Keamanan – Dampak Politik
Sejarah GHSA

• GLOBAL HEALTH SECURITY INISIATIVE 2001 diusulkan oleh FINLANDIA
• INTERNATIONAL HEALTH REGULATION 2005, WHO, bersifat non legal binding
• GHSI menjadi GHSA 2011 diusulkan oleh USA
• Secara resmi THE GLOBAL HEALTH SECURITY AGENDA (GHSA) diluncurkan FEB 13, 2014
• Negara G7 mendorong suksesnya GHSA pd JUNi 2014;

• • Selanjutnya Finlandia dan Indonesia menjadi tuan rumah sbg

  lkomitmen pengembangan GHSA dalam aksi nyata pd bln

  MAY dan AUGUST.

  GHSA 2014 di Helsinki & Jakarta

• GLOBAL HEALTH SECURITY AGENDA COMMITMENT DEVELOPMENT MEETING, HELSINKI, FINLAND, MAY 5-6, 2014

• • BUILDING GLOBAL COMMITMENT TO MULTISECTORAL

  APPROACHES TO MANAGE EMERGING ZOONOTIC DISEASE IN SUPPORT OF THE GLOBAL HEALTH SECURITY AGENDA WITHIN THE FRAMEWORK OF PUBLIC HEALTH 21-22 AUGUST 2014, JAKARTA

  Peluncuran GHSA di Gedung Putih

• Diluncurkan ol Pres Barack Obama,
• Dihadiri oleh
• – National Security Advisor Susan Rice,
• – Assistant to the President for Homeland Security and Counterterrorism Lisa Monaco,
• – SoH Sylvia M Burwell,
• – State Secretary John Kerry – SoD Chuck Hagel
• with Ministers and senior officials from 43 other countries and leading international organizations to make concrete commitments

  Kegiatan 2015 di Bangkok, Geneva, Paris, Cape Town Hanoi an Seoul

• GHSA LABORATORY MEETING 7 SD 9 MAY 2015 BANGKOK THAILAND
• Rapat World Health Assembly di Geneva 21 23 Mei 2015 dihadiri Menkes RI
• Rapat Half Day GHSA Meeting di Paris tgl 19 Juni 2015 dihadiri Dirjen P2PL
• Rapat WHO High Level Partnership, Health Security

  Emergencies Beyond Ebola, 13 sd 15 Juli 2015 Cape Town

  • Rapat GHSA Zoonotic Threat Preparation di Hanoi Vietnam 25

  sd 26 Agustus • GHSA Seoul Ministrial Meeting

  Join Statement Pres Jokowi-Pres Obama

• The two Presidents also acknowledged the need for expanding cooperation on health and to build capacity to prevent, detect and respond to global health challenges, including epidemic threats. Taking into account the expanding cooperation in this area, the two countries have committed to work on an umbrella agreement on health cooperation that will provide framework and future direction.

  The United States welcomed Indonesia’s continued leadership in the five-year initiative of the Global Health Security Agenda (GHSA) aiming for mutually agreed upon targets, including as 2016 GHSA Steering Group Chair.

  KEGIATAN 2016

• Regional Workshop: “Enhancing Regional Partnership toward

  Strengthening Laboratory System in Accelerating GHSA’s Implementation” Bangkok, Thailand - 27-29 July 2016

• Animal and Human Health Collaboration in ASEAN, Da Nang, Viet Nam - 16-18 August 2016, The 1st Joint Consultative Meeting between ASEAN Veterinary Epidemiology Group ASEAN plus three Field Epidemiology Training Network (ASEAN + 3 FETN). Concept Note: Animal and Human Health Collaboration in ASEAN
• GHSA Action Package Coordination Meeting, Jakarta, Indonesia - 23-24

  August 2016

• 3rd Annual Ministerial Meeting, The Hague, Netherlands - 12-14

  GHSA 2016 MEETINGS

• _{Package [PDF, 5.19MB]} ^{5th July 2016 - 5th Video Conference on Strengthening Laboratory Systems Action} _{Actions: Bali, Indonesia} ^{27-29 June 2016 - Advancing Global Health Security: From Commitments to}
• _{Action Package [PDF, 496Kb]}
20 June 2016 - Second GHSA Videoconference for Workforce Development<
• ^{23-28 May 2016 - World Health Assembly: Geneva, Switzerland} • _{Health Security Agenda in Supporting Countries' Capacity to Implement}
_{International Health Regulations} 23 May 2016 - Side Event during the World Health Assembly on the Role of Global<
• _Switzerland
22 May 2016 - Meeting of the Alliance for Country Assessment: Geneva,<
• ^{21 May 2016 - Steering Group Meeting: Geneva, Switzerland} • _{Workforce Development on Epidemiology Advancing IHR/GHSA [PDF, 1.3MB]}

  ^{9-10 May 2016 - Workshop on Regional Strategic Framework for Human Health}

  •

  GHSA 2016 MEETINGS

• 27-28 April 2016 - Biosafety and Biosecurity (Prevent-3) Action Package _{Stakeholders Meeting; Lisbon, Portugal} • 14-15 April 2016 - Bi-Regional Technical Consultation on Antimicrobial _{Resistance in Asia: Tokyo, Japan} • 22-23 March 2016 - High Level Conference on Global Health Security: Lyon, _France • 14 March 2016 - GHSA Alliance on Country Assessment: Geneva, Switzerland

  • 25 March 2016 - First GHSA Videoconference for Workforce Development Action

  _{Package [PDF, 152Kb]}
• 23 January 2016 - Steering Group Meeting: Geneva, Switzerland • 13 January 2016 _{Health Risk Framework for the Future"}

  _{Academy of Medicine's convened commission report and actions on a "Global}

• – Global Health Risk Framework Launch Event - The National
• 3 December 2015
• – GHSA AP3 Meeting: Copenhagen, Denmark
• 7 –9 September 2015 – GHSA 2015 High-Level Meeting in Seoul

Negara yg terlibat

• Australia, Azerbaijan, Canada, Chile, China,

  Denmark, Ethiopia, Finland, France, Georgia,

  Germany, Guinea, India, Indonesia, Israel, Italy, Japan, Jordan, Kenya, Liberia, Malaysia, Mexico, Netherlands, Norway, Pakistan, Peru, Portugal, Republic of Korea, Saudi Arabia,

  

Sierra Leone, Singapore, South Africa, Spain,

Sweden, Switzerland, Thailand, Turkey, Uganda, Ukraine, United Arab Emirates, United Kingdom, United States, Vietnam, and Yemen.

• Ada 6 peserta baru menjadikannya 50 Negara

Organisasi Dunia yg terlibat

• United Nations,
• – World Health Organization,
• – the World Organization for Animal Health – World Bank,
• – Food and Agriculture Organization,
• – INTERPOL
>African Union,
• European Commission

  BentukPendekatan

• Health Approach: Kemko PMK
• – Pendekatan Keamanan Kesehatan satu atap

• – Tidak hanya membasmi NATURAL DESEASE, tetapi juga fokus pd

  _{ancaman penyakit yg secara sengaja didesign dan dibuat untuk}

  _{menyerang manusia, hewan, pertanian yg berdampak pada} perekonomian Negara tersebut.
• Security Approch : KemkoPolhukam

  Keamanan , Penegakan Hukum dan Intelijen ^{yg melibatkan Militer, Polisi, penegak hukum,} _{dan para ahli kedokteran, kedokteran hewan, pertanian, lingkungan hidup, dan kesehatan masyarakat.}

• – Intergrasi secara profesional di bidang
• Pemangku kepentingan : Negara Negara seantoro dunia
• Badan badan PBB spt WHO, FAO, OIE, Interpol dll

Peran Dokter Masa ke Masa

• Dokter from Hero to Zero • Setara tukang parkir
• Quovadiss

  • Tren baru, tantangan baru, kesempatan

  baru
• Bermain di dua cluster
• Health Security

  Solusi Dunia GHSA Action Packages AKSELERATOR IHR 2005

• Prevent
• – Prevent 1: Antimicrobial Resistance – Prevent 2: Zoonotic Disease – Prevent 3: Biosafety and Biosecurity – Prevent 4: Immunization
• Detect
• – Detect 1: National Laboratory System – Detect 2 &amp; 3: Real-Time Surveillance – Detect 4: GHSA Reporting – Detect 5: Workforce Development
• Respond
• – Respond 1: Emergency Operations Centers

  – Respond 2: Linking Public Health with Law and Multi-sectoral

  _{Rapid Response}

  Bentuk Kerjasama l

• Multisectoral dan Multi Lateral • Act LOCALLY, NATIONALLY and GLOBALLY
• Melalui Kebijakan, Penelitian, Pendidikan CB &amp; Praktek • Tentu saja pasti menghadapi konflik kepentingan krn perbedaan budaya dan kepentingan antar Negara, antar kementerian,antar profesi dan setiap unsur punya tujuan sasaran, kepentingan &amp; sudut pandang.
• PERKUAT KERJA SAMA SIPIL MILITER DLM

  MENGHADAPI BENCANA BIOLOGI Konsep TNI Kemhan

• TNI-Kemhan berada dlm Health Cluster yi Kesehatan TNI tetapi bila eskalasi meningkat bergeser ke Security Cluster di bawah Koordinasi

  Kemko Polhukam dan TNI hanyalah salah satu

  komponen dalam sistem GHS yang luas.
• PERKUAT KERJASAMA SIPIL MILITER
• Kemhan menyusun Kebijakan &amp; Strategi :
• – Pada saat Pra Bencana – Pada saat Bencana Skala Kecil
Konsep Tahapan Penanganan Bencana Biologi

• Tahap Pra Bencana,

• – Persiapan Payung Hukum, Kebijakan, Strategi,

  Capasity Building seluruh Kementerian terkait,

  Sosialisasi Disseminati dan Advocacy GHSA

>Bencana Skala Kecil &gt; Kemkes &gt;&gt;Dokter untuk Bangsa &gt;&gt; AGENT OF DEFENSE&gt;&gt; BABINSA

• • Bencana skala Sedang, di declare sbg bencana

  nasional &gt; BNPB, UU Bencana, PP 21, 22, 23
• Bencana Skala Masif &gt; kemungkinan travel

  Tahap Pra Bencana

• Sosialisasi GHSA dan Ancaman via seminar symposium, workshop dll dll
• Menyiapkan Payung Hukum, Kebijakan dan strategi sampai ke

  SOP dan Juklap teknis

• Capasity Building Health Cluster sesuai 11 Action Package GHSA dengan mengenyampingkan hal hal yg tidak memberikan manfaat bagi NKRI
• Capasity Building Security Cluster bagi SDM dgn Pendidikan , Latihan, TTX, CPX, FTX, CIS. Ttg isolasi, dll
• Sbg ketua Troika melakukan Kerja sama militer dgn pihak asing dlm frame work biodefense, biological warfare, dan bio terrorisme. BIN BNPT BAIS BAINTELKAM POLRI
• Panduan Pelaksanaan OSLO Guide Line, IASC Guide Line,

  Bencana Skala Kecil

• Cluster PMK
• – Kemkes • Ditjen P2PL,
• Pusat Krisis Kemkes – Dinas Kesehatan/RSUD RST se Indonesia – PB IDI dan jajarannya
• – Lembaga Penelitian dan BSL 3
• – BPBD tk 1 dan 2
Bencana Skala Sedang

• Cluster nasional BNPB,
• – Dengan perkuatan lintas Kementerian dan Lembaga – Ditunjuk Inciden Commander – Yon Nubika, Yonkes, RS TNI, SDM TNI, Alutsista TNI,

  Kapal, Helicopter dll

• – BNPT ikut terlibat bila diduga bencana buatan
• – Bantuan Medis Asing Civil &amp; Military – UN Forum: IASC OCHA, WHO, FAO, OIE, WFP, FAO e
• – G to G, Mil to Mil Military Forum : APC MADRO,

  ASEAN SASOPS, IASC Guideline Bencana Skala Besar

• Cluster Security
• – Di negara Barat di kendalikan ol DKN
• – Di Indonesia UU Kamnas belum ada
• – Kemko Polhukam ambil alih
• – Presiden penanggung jawab
• – Seluruh kabinet dan lembaga tinggi Negara terlibat
• – Dampak Internasional &gt; First Second, Multi Track Diplomasi:
• Travel ban, karantina paksa
• Pengurangan arus masuk dan keluar barang di bandara dan pelabuhan _{laut, cad minyak 18 hr.}
• – Dampak Nasional
>Kerusuhan dalam negeri
• Pasien dan Keluarga yg diisolasi berontak
• Berebut vaksin, keresahan social, korban jiwa

Esklasi Bencana Biologi Heath Cluster BNPB Cluster

  Security Cluster

  Koordinator Menko PMK

Koordinonator

Ka BNPB / IC

  Koordinator Menko Polhukam

  Diagram Pelibatan TNI dlm GHSA International Security Issue

  

National Issue

Global Health Security Agenda

_{Merupakan Health Issues}

  Pang TNI &amp; Perkuatan Kapuskes TNI Dir Kadiskes TNI

  RS TNI, YONKES BNPB LED UN AGENCIES

  INT MED TEAM

  TTX Global Health Security International Conference

• Dibuka oleh Presiden di istana
• Dibiayai WHO
• Dihadiri pejabat sipil &amp; Mil 50 negara
• Output &gt;&gt; Jakarta Call for Action

Kesimpulan

• GLOBAL HEALTH SECURITY ADALAH SEBUAH TREND SECURITY YG AKAN TERUS AKTUAL DALAM BEBERAPA DEKADE KEDEPAN
• DOKTER UNTUK BANGSA ADALAH AGEN AGEN PERTAHANAN YANG BERPERAN DISEMUA TAHAPAN BENCANA BIOLOGI
• PERLU NYA SEBUAH KONSEP HOLISTIK YG

  MEMPERKUAT KERJASAMA SIPIL MILITER

  DALAM MENGHADAPI ANCAMAN

  

SEKIAN

DAN

TERIMA KASIH