Indonesia Tuberculosis Roadmap Overview, Fiscal Year 2021

Speeches Shim

This is an overview of the USAID/Indonesia FY 2021 Tuberculosis (TB) Roadmap, implemented with FY 2020 budget. It was developed in consultation with the National TB Program (NTP) and with the participation of national and international partners involved in TB prevention and care in the country.

While Indonesia has made progress over the past decade toward reducing TB incidence and increasing treatment success rates, significant challenges to eliminating TB remain. Among the top 30 high TB burden countries, Indonesia ranked third; and among the high multidrug-resistant TB (MDR-TB), Indonesia ranked fifth.1 In 2018, Indonesia had an estimated incidence of 845,000 and estimated mortality of 93,000 TB cases.2 TB is the fourth highest cause of death in Indonesia overall, and among Indonesians aged 15 to 49 years, it is the number one cause of death by a communicable disease.3 In 2018, only 568,865 (67 percent) of the 845,000 estimated TB cases were notified.4 Thus, more than one-third of TB patients remain either undiagnosed or diagnosed but not notified to the NTP. Of the new cases diagnosed and started on care, 85 percent were successfully treated.5 Additionally, in 2018, an estimated 24,000 patients developed drug-resistant TB (DR-TB)/MDR-TB; however, only 9,038 cases were diagnosed and only 46 percent of those cases were initiated on treatment.6

The current National Strategy of TB Care and Prevention in Indonesia 2020-2024 aims to accelerate the TB elimination efforts in Indonesia by 2030 and to end TB in Indonesia by 2050.7 To achieve these goals the National Strategy will strengthen leadership of district- and city-based programs; increase access to high quality, patient-centered TB diagnostic and treatment service; control TB infection and optimize the provision of TB preventive therapy (TPT); increase utilization of research results on screening technologies, diagnostics, and treatment regimens; increase the participation of communities, partners, and other multisectoral actors in TB control efforts; and strengthen program management by strengthening the overall health system.

TABLES

The following tables illustrate the distribution by technical area of the Global Fund* and USAID TB budget for Indonesia that will be used for the implementation of Indonesia’s FY21 TB Roadmap (Table 1) and the core indicators that will be used to monitor implementation of Indonesia’s TB Roadmap and the country's progress towards the United Nations General Assembly High-Level Meeting on TB targets (UNGA targets) (Table 2).

Table 1: USAID Budget for Indonesia per Technical Area*

Technical Area USAID TB budget for FY21 USAID Percentage of TB budget for FY21
REACH $5,372,719 36%
CURE $2,509,752 17%
PREVENT $2,530,909 17%
SELF-RELIANCE $4,586,620 31%
TOTAL BUDGET: $15,000,000 100%

*USAID is working with the Global Fund to provide similar budget data for next year. It is anticipated this information will be added once the discussions have been finalized.


Table 2: TB Core Indicators in Indonesia from 2015-2019 and Targets from 2020-2022

# Name 2015 2016 2017 2018 2019* 2020** 2021** 2022**
REACH: Increased DS- and DR-TB case notification
1 TB Detection 39.4% 43.3% 52.4% 66.7% 67% UNGA target: 808,400 UNGA target: 758,20000 UNGA target: 707,90000
2 Bacteriological Diagnosis Coverage (Pulmonary TB) 64.2% 58.9% 54.0% 49.7% 52%
3 Childhood TB Notifications 28,412 32,602 52,944 60,892 70,092 UNGA target: 68,000 UNGA target: 69,000 UNGA target: 70,000
4 Drug-Resistant TB Notifications 2,173 2,757 5,121 9,118 11,496 UNGA target: 14,200 UNGA target: 20,500 UNGA target: 21,900
5 Private Sector TB Notifications 31,002 37,541 58,633 101,839 109,216
6 Contact Investigation Coverage*** 3%
CURE: High treatment success rate in DS- and DR-TB
7 TB Treatment Success Rate 85.1% 85.8% 84.7% 83.0%
8 Drug-Resistant TB treatment Success Rate 46.9% 47.1% 45%
PREVENT: Prevent TB transmission and development
9 TPT Coverage 591 877 13,761 21,841 27,959 UNGA target: 305,490 UNGA target: 478,650 UNGA target: 587,600
SELF-RELIANCE: Commitment and sustainability
10 Proportion of Domestic Financing for TB 68.0% 38%

*Provisional data.
**Projected UNGA targets.
***Based on available data.

Date 
Tuesday, September 29, 2020 - 9:30am