Tuberculosis in Indonesia: A National Public Health Emergency
Written by Mutiara Az Zahra
“Tuberculosis is preventable and curable, yet it continues to claim lives. Ending TB in Indonesia
requires early detection, complete treatment, and collective action.”
Tuberculosis (TB) remains one of the most significant public health challenges in
Indonesia. Despite advances in medical science, diagnostic technology, and treatment, the
disease continues to affect millions of people worldwide. According to the World Health
Organization (WHO, 2025), an estimated 10.7 million people developed TB globally in 2024,
and approximately 1.23 million people died from the disease. Indonesia accounted for around
10% of global TB cases, making it one of the countries with the highest TB burden. These
figures highlight the urgent need to strengthen prevention, early diagnosis, access to healthcare,
and treatment adherence in Indonesia.
Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, a
bacterium that primarily affects the lungs but can also affect other organs, including the lymph
nodes, bones, kidneys, and brain. TB spreads through the air when a person with infectious
pulmonary TB releases bacteria by coughing, sneezing, speaking, or breathing. However, not
everyone infected with TB bacteria develops active disease. Some individuals have TB
infection without symptoms and cannot transmit the bacteria. Active TB disease may develop
when the bacteria multiply in the body, particularly when the immune system is weakened
(WHO, 2026).
The symptoms of active TB commonly include a persistent cough, chest pain, fatigue,
fever, night sweats, and unexplained weight loss. Some individuals may also experience
coughing up blood. Because symptoms can develop gradually and may initially appear mild,
people sometimes delay seeking medical attention. This delay can increase the risk of
transmission, especially in households, workplaces, schools, and other crowded environments.
Recognizing the symptoms and seeking medical evaluation early are essential steps in reducing
the spread of TB.
Indonesia’s TB burden reflects a combination of epidemiological, socioeconomic, and
healthcare-related challenges. According to WHO (2026a), more than one million people were
estimated to be diagnosed with TB in Indonesia in 2025, while annual deaths were estimated
at approximately 134,000. These figures demonstrate that TB remains a serious national health
concern. Furthermore, WHO’s epidemiological review identified gaps in case detection and
reporting, particularly among people who had not received a diagnosis and cases
managed by healthcare facilities that did not consistently report their data. In 2023,
approximately 140,000 people with TB were estimated to remain undiagnosed, emphasizing
the importance of improving surveillance and access to diagnostic services (WHO, 2025a).
Several factors contribute to the continued transmission of TB in Indonesia.
Overcrowded housing, inadequate ventilation, poverty, undernutrition, and limited access to
healthcare can increase vulnerability to infection or delay diagnosis. In addition, people living
with HIV, individuals with diabetes, and those with weakened immune systems have a higher
risk of developing active TB disease. Social stigma and misconceptions about the disease may
also discourage individuals from seeking medical assistance or disclosing their condition to
healthcare providers. Consequently, TB control requires more than medical treatment; it also
requires improvements in living conditions, public health education, social support, and
equitable access to healthcare (WHO, 2026).
The consequences of TB extend beyond physical illness. Untreated or inadequately
treated TB can lead to severe complications, disability, and death. The disease may also affect
educational participation, employment, household income, and family well-being. Patients and
their families may experience financial difficulties because of transportation expenses, time
away from work, and other indirect costs associated with treatment. In addition, stigma can
contribute to social isolation and emotional distress. Therefore, TB prevention and control
should address both the clinical needs of patients and the broader social circumstances that
influence their health outcomes.
Early diagnosis is a critical component of TB control. WHO recommends rapid
diagnostic tests for individuals with signs and symptoms of TB because these tests can help
identify the disease and guide treatment decisions. Depending on the clinical situation,
healthcare professionals may also use sputum examination, chest X-rays, and other
investigations. In Indonesia, strengthening the role of primary healthcare facilities, including
Puskesmas, is important for improving access to screening, diagnosis, referral, and follow-up
services. Community-based case finding and more effective reporting systems can also help
identify individuals who might otherwise remain undiagnosed (WHO, 2025; WHO, 2026).
TB is preventable and curable when appropriate care is provided. Treatment for active
TB disease generally involves a combination of antibiotics taken over several months, with the
regimen and duration determined by healthcare professionals according to the patient's
condition and the drug susceptibility of the bacteria. Patients must follow the prescribed
treatment plan and attend scheduled medical evaluations. Stopping treatment prematurely or
taking medication inconsistently can contribute to treatment failure, relapse, and drug
resistance. Drug-resistant TB is particularly concerning because it requires specialized
treatment and can be more difficult to manage. Healthcare workers, family members, and
treatment-support programs play an important role in helping patients complete therapy safely
and successfully (WHO, 2026).
Prevention requires coordinated action at individual, community, and national levels.
Individuals should seek medical evaluation when experiencing symptoms suggestive of TB,
maintain good respiratory hygiene, and ensure adequate ventilation in indoor spaces. People
who have been in close contact with someone diagnosed with infectious TB should follow
healthcare professionals' recommendations regarding screening and preventive treatment. The
Bacille Calmette–Guérin (BCG) vaccine also helps protect young children against severe forms
of TB. At the community level, health education should address misconceptions, encourage
early testing, and reduce discrimination against affected individuals. At the national level,
sustained investment in diagnostic services, healthcare personnel, surveillance systems, and
patient support is necessary to strengthen TB control (WHO, 2026).
Indonesia's efforts to eliminate TB also depend on cooperation between government
institutions, healthcare providers, educational institutions, community organizations, and the
public. The WHO-supported national TB programme reviews conducted in 2025 identified
priorities that include improving people-centred healthcare services, strengthening
surveillance, and addressing gaps throughout the process of diagnosis and treatment. These
efforts support the development of stronger national strategies to accelerate progress toward
ending TB. However, achieving this goal requires consistent implementation, adequate
resources, reliable data, and meaningful participation from affected communities (WHO,
2026).
Public awareness is equally important in addressing the TB emergency. Educational
campaigns should communicate that TB is an airborne infectious disease, that early diagnosis
can reduce transmission, and that effective treatment is available. People affected by TB should
receive respectful care and support rather than blame or discrimination. Schools, universities,
workplaces, and community health centres can serve as important settings for distributing
accurate information and encouraging appropriate health-seeking behaviour. By improving
health literacy and promoting supportive environments, communities can help reduce delays
in diagnosis and improve treatment outcomes.
In conclusion, tuberculosis remains a major public health emergency in Indonesia
because of its high disease burden, persistent gaps in case detection, socioeconomic
determinants, and challenges in ensuring successful treatment. Although TB is preventable and
curable, reducing its impact requires comprehensive and sustained action. Early diagnosis,
appropriate treatment, preventive measures, stronger health systems, and public education must
work together to control transmission and prevent avoidable deaths. Most importantly, ending
TB should be recognized as a shared responsibility that requires government commitment,
professional healthcare services, community participation, and support for every person
affected by the disease.
“End the stigma, find TB early, complete the treatment, and protect every community. Indonesia
can move closer to a future free from tuberculosis.”
References
World Health Organization. (2025). Global tuberculosis report 2025.
https://www.who.int/publications/i/item/9789240116924
World Health Organization. (2025, July 1). Strengthening TB surveillance to accelerate
Indonesia’s path to elimination. https://www.who.int/indonesia/news-room/item/01-07-2025-
strengthening-tb-surveillance-to-accelerate-indonesia-s-path-to-elimination
World Health Organization. (2026, March 27). Building Indonesia’s tuberculosis strategy with
evidence and partnership. https://www.who.int/indonesia/news-room/item/27-03-2026-
building-indonesia-s-tuberculosis-strategy-with-evidence-and-partnership
World Health Organization. (2026, March 24). Tuberculosis. https://www.who.int/news-
room/fact-sheets/detail/tuberculosis
