Indonesia still struggles to combat tuberculosis, with the second highest number of cases in the world.
One study in 2021 estimated that Indonesia had an alarming incidence rate of TB, 759 cases per 100,000 people, more than twice the World Health Organization’s estimate of 354 points per 100,000 Indonesians. This compares to a global average of 134 cases per 100,000 people.
Indonesia, undeterred by TB’s challenges, has set ambitious goals to reduce TB cases from 190 to 100,000 people in 2024 to 65 to 100,000 by 2030.
The country needs to increase funding urgently in order to combat the potentially fatal but preventable infectious diseases.
Insufficient funding is a major obstacle to the fight against TB in Indonesia. Sustained adequate funding will ensure that essential resources, diagnostic instruments, medications, and healthcare services are available to prevent, diagnose, and treat TB effectively.
A lack of funding could lead to more illnesses
Lack of funding, also known as the financing gap can result in inadequate diagnostic equipment and tools, leading to delayed or inaccurate diagnosis. These delays can have serious consequences.
Studies show that delaying treatment of TB can increase the risk for individuals and communities.
Worldwide, 1.6 million people died from TB in 2021, making it the 13th cause of death and second most infectious killer, after COVID-19.
Indonesia’s national strategy states that the country must spend Rp47.3 billion (US$3billion) between 2020 and 2024 in order to combat TB. The budget available for this period is Rp15.7 trillion (US$990 million).
Indonesia lacks the financial resources to pay for these extra measures.
WHO Global Tuberculosis Report stated that Indonesia needed US$429 for TB diagnosis, prevention, and treatment. It also required US$87 for tuberculosis. This totals US$516 for Indonesia. It has secured just US$111.
Since 2009, WHO data indicates that Indonesia consistently fails to meet the required TB funding requirements. In fact, only 41% of needed TB programs are funded each year.
The financing gap limits the availability of essential drugs for TB treatment. This is a particularly serious issue, given the emergence of drug-resistant strains, which complicate treatment efforts.
The pandemic has hit TB funding.
The COVID-19 pandemic in Indonesia has worsened TB financing gaps.
The government changed its priorities to focus on COVID-19 prevention and treatment during the pandemic. It reallocated its health budget.
WHO reported that Indonesia’s funding for TB decreased by around 8.7% from 2019 to 2020.
On closer inspection, two significant reasons are revealed relating to factors that contribute to the funding deficit.
The first is the inadequacy of funds to cover the cost of TB services. The impact and reach of the programs are limited.
Patients also tend to prefer hospitals for diagnosis and treatment over local primary care centers and clinics. Higher treatment costs at hospitals burden the National Health Insurance System.
The lack of involvement by the private sector in the diagnosis, reporting, and treatment of patients is another factor that exacerbates the problem.
What should we be doing now?
It is essential to increase domestic funding for TB programs.
The Indonesian Government should allocate a larger proportion of its national budget for TB research and prevention, as well as a greater portion to control TB.
Incorporating externally funded TB programs in the National Health Care system will ensure their sustainability and alignment with the national healthcare framework.
The importance of strengthening the healthcare system cannot be overstated. This includes enhancing the infrastructure and capacity of local clinics and health centers, as well as training healthcare professionals, and improving diagnostic and therapeutic services.
Explore innovative funding pathways, such as public-private partnerships or international funding mechanisms.
Closing the TB funding gap is crucial, not only for the health of patients but also to safeguard the socioeconomic stability and well-being of the community as an entire.
