Jakarta (ANTARA) -
Tuberculosis has existed since ancient times, yet it remains one of the leading causes of death in the modern era.
The World Health Organization (WHO) reported that in 2023, some 1.25 million people died from TB, and 161 thousand of them were people living with Human Immunodeficiency Virus (PLHIV).
TB poses the greatest threat to PLHIV and is also the leading cause of death related to antimicrobial resistance. Despite being preventable and treatable, 10.8 million people globally suffer from this disease. The figure is dominated by men, with six million, 3.6 million female patients, and 1.3 million children.
As a result, TB eradication is included in the Sustainable Development Goals (SDGs), targeted for achievement by 2030, including in Indonesia. This goal is also listed as a health sector target in President Prabowo Subianto's Quick Win Best Results Program (PHTC).
Director of Prevention and Control of Infectious Diseases at the Ministry of Health Ina Agustina Isturini stated that data as of early March 2025 showed that as many as 889 thousand, or 81 percent of cases, had been identified out of the goal of 1,092,000 TB case detections.
Although progress in case detection and treatment continues annually, there is still a long way to go to eliminate the disease.
In 2025, the government aims to reduce TB incidence by 50 percent, aligning with the global target of 163 cases per 100 thousand population. Currently, Indonesia's incidence rate stands at 388 per 100 thousand population.
The government is also accelerating treatment coverage to achieve a 90 percent success rate while ensuring treatment reaches 90 percent of patients.
Prioritizing prevention
To combat this ancient disease, Indonesia is making four major efforts: case detection, prevention, health promotion and multi-sector involvement, and treatment.
Isturini noted that case detection efforts are being conducted using X-rays in active case finding (ACF) and also integrated with other quick win programs, namely Free Health Check (CKG).
Additionally, incentives are provided for case detection at primary health facilities (FKTP), and special hospitals are being developed to treat drug-resistant TB.
Regarding case finding, the government also conducts screenings in high-risk areas for TB transmission, such as correctional institutions (prisons).
Deputy Minister of Health Dante Saksono Harbuwono stated that the risk of TB transmission in prisons is 10 times higher due to the high population density, sometimes exceeding capacity.
Based on provincial identification results, Banten is recorded to have the best TB handling coverage, including Tangerang City. According to reports, around 80 percent of inmates at the Class IIA Tangerang Women's Prison had consumed TB-prevention drugs.
“We hope various programs in Tangerang can be replicated by other areas for a more optimal TB identification process,” Harbuwono remarked.
As for TB prevention, the government is pushing efforts in drug provision for patients diagnosed with latent TB; TB vaccine research; training related to TB infection; policies on providing Tuberculosis Prevention Therapy (TPT) for household contacts who are negative for TB; and integration of active case finding with the provision of TPT.
Regarding vaccine research, Indonesia is actively conducting vaccine research on the global stage.
After the discovery of TB in 1882, the health sector developed a vaccine with the potential to protect adults from exposure to the Mycobacterium tuberculosis bacteria responsible for tuberculosis.
Director General of Pharmacy and Medical Devices of the Ministry of Health Lucia Rizka Andalusia stated that several TB vaccine candidates are entering the clinical trial stage nationally and globally. Indonesia also plays an important part in vaccine development by participating in the "TB M72 Vaccine" clinical trial program.
Currently, 1,800 people in Indonesia have taken part in this clinical trial, with a target of two thousand participants in the "TB M72 Vaccine" clinical trial.
National TB Vaccine Researcher Prof. Dr. Erlina Burhan, Sp.P(K), explained that the vaccine aims to protect teenagers and adults from TB as a follow-up to the BCG vaccine, which has been proven to protect only the infant age group.
The TB M72 vaccine research by Indonesia is one of the studies that is part of a global study followed by four other countries: South Africa, Kenya, Zambia, and Malawi.
Research on this vaccine took place at several institutions: the University of Indonesia, Padjajaran University, and Persahabatan General Hospital.
The Health Ministry is also urging the public to report TB cases. This was due to underreporting, which complicates treatment efforts.
Hence, the ministry is teaming up with the Ministry of Villages and Development of Disadvantaged Regions (PDT) to implement TB Alert Villages and allocate village funds to combat the disease.
The ministry is also pushing education to build public awareness and eliminate stigma, such as reporting on current TB issues, highlighting the importance of improving health services and social protection for people with TB, and policy advocacy.
In addition, nutritional fulfillment is a highlight in the efforts to prevent TB.
According to Head of the Food and Drug Monitoring Agency (BPOM) Taruna Ikrar, nutritional problems, such as malnutrition, can reduce a person's immune system, increasing susceptibility to TB infection and also the risk of reactivation of dormant or inactive TB.
In Indonesia, 80 percent of the children face nutritional challenges: 21.6 percent experience stunting, 40 percent suffer from micronutrient deficiencies such as iron and vitamins, and the other 20 percent have excess nutrition leading to metabolic diseases that can trigger immunity problems.
The government also runs the Free Nutritious Meals (MBG) program as an effort in nutrition fulfillment to increase the body’s immunity, with BPOM helping to supervise as part of TB prevention efforts.
The need for new drugs
One of the challenges in eliminating tuberculosis is the existence of drug-sensitive TB (TBSO) and drug-resistant TB (TBRO). Drug-resistant TB, where pathogens resist standard treatments, stems from several factors, including misdiagnosis, inadequate treatment protocols, non-compliance with health workers' recommendations, and irregular medication use.
Data from the Ministry of Health reveals that in 2024, the success rate for TBSO treatment in 2024 reached 84 percent but only 58 percent for TBRO. In fact, the success target is 90 percent for TBSO and 80 percent for TBRO.
Ikrar emphasized that such antimicrobial resistance (AMR) underscores the critical need for new drugs.
Several types of drugs are currently expected to handle this problem, but their efficacy still needs to be tested.
His side is also committed to ensuring the availability of antibiotics for TB treatment to suppress TB cases.
There are still several stages ahead before the country is free from TB. However, consistent, collaborative, and massive efforts can accelerate humanity's efforts to eradicate the disease.
