Indonesia defends TB vaccine trial as Bill Gates conspiracy theories spread: ‘not guinea pigs’

The controversy began after President Prabowo Subianto said that Bill Gates was developing a tuberculosis vaccine to be tested in Indonesia

Indonesia’s role in a high-profile tuberculosis (TB) vaccine trial funded by the Bill & Melinda Gates Foundation has unleashed a wave of conspiracy theories and misinformation online – prompting health officials to clarify that the country was not being treated as a “guinea pig” and that the jab was not developed by Gates himself.

The backlash began after President Prabowo Subianto met Microsoft co-founder and philanthropist Bill Gates at the presidential palace in Jakarta on May 7. Following the meeting, Prabowo told reporters that Gates was “developing a TB vaccine for the world” and that “Indonesia will be one of the places to test [the vaccine]”.

He praised Gates’ contributions to the country, noting that the foundation had provided more than US$159 million in grants since 2009, mostly for health programmes. Prabowo also announced plans to award the billionaire Indonesia’s highest civilian honour during the United Nations General Assembly in New York this September, saying he would propose the decoration at a coming meeting of the honorary council.

But Prabowo’s comment about Indonesia becoming the testing ground for the vaccine drew fire online, igniting a wave of misinformation on social media claiming the vaccine is unsafe and questioning Gates’ intention.

“[Indonesia] received a grant of 2.5 trillion rupiah (US$151 million) and Indonesia will be the testing ground for Bill Gates’ TB vaccine. There’s no such thing as a free lunch,” said one social media user.

“Why does Bill Gates want to test the TB vaccine in our homeland, why doesn’t he test it in his homeland?” asked another. “Why don’t other countries want their people to be used as guinea pigs? Only poor countries are targeted?” asked a third.

Many users referenced long-standing conspiracy theories linking Bill Gates to vaccine-related plots. Such rumours gained traction during the Covid-19 pandemic, falsely claim Gates seeks to control or harm populations through vaccination programmes – allegations that have been widely debunked but continue to circulate online.

Not a Bill Gates vaccine

Health Minister Budi Gunadi Sadikin has dismissed the rumours and conspiracy theories, saying that Indonesia is not a “guinea pig” for the TB vaccine, named M72/AS01E.

“This is to educate the public, as well, that we are not guinea pigs. [The rumour] was intentionally spread so that people do not want to be vaccinated. In fact, the consequences can be very fatal, 100,000 people could die because of something like this,” Budi told reporters on May 9, adding that the government was pushing for production of the factory to be done in Indonesia.

Erlina Burhan, professor of pulmonology and respiratory medicine at the University of Indonesia, said the country’s involvement in the clinical trial would support its efforts to eliminate TB, as Indonesia has the second-highest number of cases in the world after India.

TB is a serious illness caused by bacteria that primarily affects the lungs and spreads through the air via coughs, sneezes, talking, spitting, laughing and singing.

It’s very wrong to say that we would be guinea pigs. It is very demeaning to this scientific activityErlina Burhan, pulmonology and respiratory medicine professor

Indonesia recorded 889,000 TB cases last year, according to the World Health Organization (WHO). The disease claims 125,000 lives each year in the country.

“It’s very wrong to say that we would be guinea pigs. It is very demeaning to this scientific activity. It follows very strict scientific principles, and it is prioritising the safety of its participants,” Erlina, who is the principal investigator in M72’s clinical trial in Indonesia, told This Week in Asia.

“We go through all the rules. We studied the protocol, and we submitted the trial to a health committee. We asked permission from the authorised authorities, such as The National Agency of Food and Drug Control.”

According to the Health Ministry, the M72 TB vaccine clinical trial has entered its third phase, involving over 20,000 participants across Indonesia, South Africa, Kenya, Zambia, and Malawi. In Indonesia, participant selection was completed on April 16, with about 2,100 individuals chosen.

The monitoring stage of the participants will continue until 2028, Erlina said.

“This is not a vaccine made by Bill Gates. During 1999-2013, the vaccine development was funded by GSK,” she said, referring to the British pharmaceutical company formerly known as GlaxoSmithKline.

“Once [the trial] entered phase 2, it needed a lot of funding because it was carried out simultaneously in several countries. The number of participants was greater, so they finally looked for financial support. The Bill and Melinda Gates Foundation was willing to fund it,” Erlina said.

According to the WHO, the second clinical trial of the M72 vaccine, which took place in South Africa, Kenya, and Zambia, achieved 50 per cent efficacy.

Tjandra Yoga Aditama, chairman of the Indonesian Lung Doctors Association, said it would be “very good” for the world if the M72 vaccine works to prevent TB infection.

“The current TB vaccine, the BCG [Bacillus Calmette-Guérin] vaccine, has been around since 1921, it was [invented] more than 100 years ago. It can only be used to prevent severe TB [dissemination] in children, so its ability is still limited,” Tjandra, who is not involved in the clinical trial, said.

To prevent further misinformation about the vaccine, Tjandra suggested the government provide “a clear explanation to the public” about the clinical trial, featuring some of the trial’s participants.

TB stigma

One reason TB remains prevalent in Indonesia is the inadequate housing in major cities, which often features damp and dusty environments. Additionally, malnutrition was a significant issue, particularly among poor communities, Erlina said. Among adults, habits such as smoking and a sedentary lifestyle could weaken the immune system and played a role in the spread of the disease, she said.

TB was curable if the patient received proper treatment, but the lingering social stigma, including the belief that the disease was caused by witchcraft, had hindered many people from getting themselves checked, she said.

“People are afraid of being ostracised or being fired from their jobs if they are [diagnosed with] TB. This stigma is still extraordinary. It is our duty to tell the public that TB is a contagious disease, but it can be treated until cured, so there is no need to be afraid,” Erlina said.