Estimated Economic Losses from Foodborne Diseases Cases Associated with the Free Nutritious Meal (MBG) Program in Indonesia

The Free Nutritious Meal Program (Makan Siang Gratis, MBG) has been imple- mented nationwide in Indonesia since January 2025 as one of the government’s flagship social interventions. However, between January and November 2025, a total of 15,117 foodborne diseases cases linked to MBG meals were recorded across Indonesia, raising concerns regarding food safety, program governance, and the unintended economic burden borne by households and the broader health system. This study employs the Cost of Illness (COI) framework to quantify the economic burden of MBG-related foodborne diseases. COI is a well-established method used to estimate the total direct medical costs, indirect productivity losses, and out of pocket (OOP) expenditures attributable to a disease or diseases. The approach assumes that the economic losses caused by diseases represent the potential economic benefits that could have been realized if the disease had been prevented. This study provides an evidence-based assessment of the total eco- nomic burden generated during MBG’s first year of implementation. This study finds the total societal loss becomes substantial, rising from USD 516,298 in the low scenario to USD 833,186 in the high scenario. The findings offer critical insights for policymakers regarding the cost-effectiveness, risk management, and sustainability of large-scale feeding programs in Indonesia.