Indonesia’s Battle Against Tuberculosis: Progress and Challenges in achieving TB-Free Goals
Tuberculosis (TB) remains one of the most pressing global health challenges, with indonesia bearing a significant burden. Over the past 200 years, TB has claimed 1 billion lives worldwide, and Indonesia ranks second globally in TB-related deaths. Despite efforts to combat the disease, the country continues to face hurdles in meeting its aspiring targets for detection, treatment, and prevention.
At the TB Free Indonesia event held on January 21, 2025, Ina Agustina, Director of Infectious Disease Prevention and control at the Ministry of Health, highlighted both progress and gaps in the nation’s fight against TB. “So, if you look at it, there has been an increase in case detection and treatment. But compared to this target, we still have to work hard, because based on this target it has not been achieved,” she stated.
The Numbers Behind the Struggle
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According to the ministry of Health, the target for TB case detection in 2024 was 900,000 cases. However,only 860,100 cases were detected,achieving 95.6% of the goal. While this represents progress, it underscores the need for more robust efforts.
The treatment landscape also reveals significant shortfalls. For TB SO (sensitive to first-line drugs) and TB RO (resistant to first-line drugs), the treatment coverage targets were 100%, but only 89% and 68% were achieved, respectively. Similarly, treatment success rates fell short:
- TB SO: Target of 90%, achieved 83%.
- TB RO: Target of 80%, achieved 57%.
Preventive measures also lagged behind expectations. The provision of TB preventive therapy (TPT), aimed at 50% coverage, reached only 17.6%. “Apart from that, there is still no contact with TB patients, so we have only detected active TB cases. Though, in contact with patients, they should be given protective therapy so that it does not become active later.Well, this is still a challenge,” Ina explained.
A Call for Collaborative Action
Addressing TB is not a task for the health sector alone. Ina emphasized the need for a pentahelix approach, involving the goverment, academics, society, and the private sector. “It takes pentahelix efforts, government, academics, society, and the private sector, who must work together to solve the TB problem. Because this is a complex problem and requires handling from various sides and various angles,” she concluded.
Key Data at a Glance
| Indicator | Target | Achieved | Gap |
|—————————–|————|————–|—————|
| TB Case Detection | 900,000 | 860,100 | 39,900 (4.4%) |
| TB SO Treatment Coverage | 100% | 89% | 11% |
| TB RO Treatment Coverage | 100% | 68% | 32% |
| TB SO Treatment Success | 90% | 83% | 7% |
| TB RO Treatment Success | 80% | 57% | 23% |
| TB Preventive Therapy (TPT) | 50% | 17.6% | 32.4% |
The Road Ahead
While Indonesia has made strides in detecting and treating TB, the gaps in coverage and success rates highlight the need for intensified efforts.Strengthening preventive measures, expanding contact tracing, and fostering multi-sector collaboration are critical to achieving the nation’s goal of a TB-free Indonesia.
The fight against TB is far from over, but with unified action and sustained commitment, Indonesia can turn the tide against this centuries-old adversary.
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Unraveling Indonesia’s Tuberculosis Battle: A Conversation with Dr. Rifki Arks, Epidemiologist Specializing in TB Control
Introduction:
Indonesia’s decades-long struggle against tuberculosis (TB) continues, as the country ranked second globally in TB-related deaths. To shed light on the progress, challenges, and obstacles in achieving a TB-free Indonesia, Senior Editor of world-today-news.com spoke with Dr. Rifki Arks, an epidemiologist and TB control specialist, who offered insights into the country’s ongoing battle against this ancient yet persistent foe.
Current State of TB in Indonesia: Progress and Gaps
Sr. Editor (SE): Dr. Arks, let’s start by discussing the current state of TB in Indonesia. What has been achieved, and where are the significant gaps?
Dr. Rifki Arks (RA): Thank you for having me. Indeed,Indonesia has made some progress in the fight against TB. We’ve seen a rise in case detection and treatment, but we’re still falling short of our targets. As of 2024, we detected around 860,100 cases out of a target of 900,000, and treatment coverage for both sensitive and resistant strains was lower than desired.
TB Detection: Too Far from the Target
SE: The 95.6% case detection rate shows enhancement, but it’s quite distant from the goal. Why do you think we’re still far behind?
RA: There are several reasons for this. Firstly, stigma and lack of awareness lead many TB patients to delay seeking help, which hinders early detection. secondly, our healthcare system’s accessibility and funding remain significant barriers, particularly in rural and remote areas. Lastly,the relentless spread of airborne TB makes contact tracing and containment challenging.
Treatment Challenges: Resistant Strains persist
SE: We’ve seen encouraging treatment success rates for TB sensitive to first-line drugs but not for resistant strains.How can we bridge this gap?
RA: TB resistance is indeed our Achilles’ heel. First, we need to improve early detection of drug-resistant TB to start appropriate treatment promptly. Multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) require longer, more costly, and harsher treatments, making them formidable obstacles.Strengthening both public and private sectors’ capability to treat these cases is crucial.
Prevention: A Long Road Ahead
SE: TB preventive therapy (TPT) has a dismal 17.6% coverage. What strategies can we adopt to boost preventive efforts?
RA: Expanding access to preventive therapy, particularly for high-risk groups like children and people living with HIV, is crucial. We must also integrate TB prevention into routine healthcare services and raise public awareness about the importance of preventive treatment. Moreover, contact tracing efforts need to be significantly ramped up to identify and treat infected individuals before they develop active TB.
Bridging Gaps: The Pentahelix Approach
SE: Ina Agustina emphasized the need for a pentahelix approach involving government, academics, society, and the private sector. How can we foster better collaboration among these stakeholders?
RA: Collaboration is key, and it should happen at every level. We need joint planning, funding, and implementation of TB control programs. The private sector can assist with financing and improving diagnostics and treatment options, while academics can aid in research and developing innovative strategies. Community engagement allows us to tackle stigma,raise awareness,and ensure-beneficial health practices.
The Road Ahead: Stepping Up Our Fight Against TB
SE: Despite the challenges, Indonesia is committed to becoming TB-free. What are some steps we can take to accelerate progress?
RA: We need to prioritize and invest more in TB control efforts. Strengthening healthcare systems, focusing on high-burden areas, improving diagnostics and treatment protocols, and intensifying research are all critical. Additionally, we must ensure that our efforts align with the World health Association’s End TB Strategy and the broader Enduring Advancement Goals.
SE: Thank you, Dr. Arks, for your insightful conversation on Indonesia’s ongoing TB battle.Your expertise sheds light on the path ahead as we fight to create a TB-free Indonesia.
RA: My pleasure. We must stay committed and work together to overcome this ancient disease once and for all.
