JAKARTA: Health experts have called for faster tuberculosis prevention and response efforts, warning that the climate crisis could increase people\u2019s vulnerability to the disease and complicate efforts to eliminate it, particularly in high-burden Asian countries such as Indonesia.<\/p>\n
Tuberculosis, or TB, is a contagious bacterial infection that primarily attacks the lungs.<\/p>\n
It infected at least 10.7 million people and claimed 1.23 million lives in 2024.<\/p>\n
Much of the global burden is concentrated in Asia, with Indonesia accounting for 10 per cent of cases, the second-highest proportion after India, at 25 per cent.<\/p>\n
The situation could be exacerbated by the climate crisis, which is driving more frequent extreme weather events and record-breaking temperatures, making TB increasingly difficult to control, according to Indian infectious disease specialist Subramanian Swaminathan.<\/p>\n
Poor environmental and social conditions, including overcrowding, inadequate ventilation, food insecurity and malnutrition, could increase transmission and disrupt access to healthcare during extreme weather events.<\/p>\n
\u201cWith crowding, urbanisation and mass gatherings, transmission becomes very, very fast,\u201d Swaminathan said on 9 July on the sidelines of the Asia-Pacific International Roche Infectious Disease Symposium (APAC-IRIDS) 2026 in Bangkok.<\/p>\n
Mumbai was one example, he said.<\/p>\n
People living in one of the world\u2019s most densely populated cities rely heavily on air conditioning to cope with extreme heat, reducing ventilation and increasing the risk of TB transmission.<\/p>\n
Swaminathan acknowledged that evidence directly linking climate change to TB remained limited and understudied.<\/p>\n
However, researchers might not have long to examine the relationship.<\/p>\n
\u201cMy worry is that we don\u2019t have too much time to figure all of this out before this becomes a significant problem,\u201d he said.<\/p>\n
Climate change-driven floods have disrupted access to TB services in Pakistan, said epidemiologist Razia Kaniz Fatima.<\/p>\n
The disruption has forced the authorities to adopt new approaches, including courier services to transport medicines and diagnostic samples.<\/p>\n
\u201cFor Pakistan and other high-burden countries suffering from extreme weather conditions, strategies and interventions must become a priority, so that we are better prepared whenever such disasters occur,\u201d she said.<\/p>\n
To address disaster-related challenges, Fatima suggested testing patients for TB and other comorbidities, such as diabetes, during a single visit.<\/p>\n
This would shorten the diagnostic process and allow treatment for multiple conditions to begin earlier.<\/p>\n
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Pulmonologist Erlina Burhan of Jakarta-based Persahabatan Hospital also advised the authorities to go beyond business as usual by conducting active case-finding and identifying latent TB infections.<\/p>\n
People with latent infections carry TB bacteria but have not yet developed symptoms.<\/p>\n
The bacteria can later progress into active disease.<\/p>\n
Indonesia has struggled to improve its TB detection rate.<\/p>\n
Of the estimated one million TB cases recorded each year, the highest number detected was about 885,000 in 2024, leaving approximately 150,000 patients undiagnosed.<\/p>\n
\u201cThese people are still in the community, coughing and continuing to spread the disease,\u201d Erlina said on the sidelines of APAC-IRIDS 2026 in Bangkok.<\/p>\n
\u201cThat\u2019s why finding every possible case is no longer optional.\u201d<\/p>\n
As widespread screening can be costly in countries such as Indonesia, Erlina urged the authorities to prioritise testing among high-risk groups.<\/p>\n
These include household members of TB patients, children under five and people living in overcrowded settings such as prisons.<\/p>\n
She also reminded the authorities to focus on treatment, as many patients fail to complete the months-long course because of financial constraints, stigma and limited access to healthcare.<\/p>\n
Incomplete treatment increases the risk of drug-resistant TB and allows transmission to continue.<\/p>\n
Indonesia aims to eliminate TB by 2030 by reducing the incidence rate to 65 cases per 100,000 people.<\/p>\n
In 2024, the country recorded an estimated 1.08 million TB cases, equivalent to 382 cases per 100,000 people.<\/p>\n
The government began shifting its TB-control strategy this year.<\/p>\n
After previously focusing mainly on treating patients, it is now prioritising the identification of undiagnosed cases by tracing the household contacts of active patients to curb transmission, Second Deputy Health Minister Benjamin Paulus Octavianus said on 7 July.<\/p>\n
The ministry plans to conduct mass screening by integrating TB checks into the free health-screening programme beginning this month.<\/p>\n
The free screening initiative, one of President Prabowo Subianto\u2019s flagship programmes, was introduced last year and has begun incorporating TB testing in 13 municipalities in Central and West Java.<\/p>\n
\u201cThe goal is not only to detect active TB cases but to identify latent TB as well among high-risk contacts, so they can receive preventive TB treatment,\u201d Benjamin said on Wednesday. – Jakarta Post\/ANN<\/p>\n
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