According to the Institute for Health Metrics and Evaluation (IHME), TB is the 10th leading cause of death in Indonesia at 7.1%, after heart disease, cancer and diabetes. Also, at 17.03% smoking is the second highest risk factor for death after cardio vascular disease.
That is why strong coordinated actions are an absolute must to end both- TB and tobacco smoking- along with prevention of NCDs, and promotion of other health activities. "It is necessary to strengthen the strategy in supporting the achievement of National Medium term Development Plan (RPJMN) 2020-2024 to reduce the prevalence of smokers aged 10-18 years and eliminate TB in Indonesia," Sadikin said. He called for stronger implementation of a range of evidence-based tobacco control measures, such as ban on smoking in public places, quit-tobacco-smoking services to help people (and TB patients) to quit the addiction, among others.
Sadikin also shared that during COVID-19, the number of people who could get diagnosed with TB in a year had dipped to around half a million but in 2021 it again picked up to over 717,000. But, over 200,000 people were missing from TB care services in 2021. He underlined the importance of reaching out to everyone with TB disease with the full cascade of health services, and ensuring that everyone is on treatment. In 2021, 86% of those who were diagnosed with drug-sensitive TB were put on treatment, out of which 87% reported treatment completion in Indonesia. However, only one-third of those with drug-resistant TB were put on treatment in the same year. Sadikin called for ensuring every person with TB should get full cascade of services if we are to end TB.
"TB is preventable. Each of the 969,000 people who got TB disease in Indonesia in 2021, is a grim reminder that we could have done better to prevent TB. If we are to end TB by 2030 we also need stronger actions against risk factors that put people at risk of TB. For example tobacco use is entirely preventable, but sadly continues to be a major risk factor for not just TB but also NCDs," said Dr Tara Singh Bam, Asia Pacific Director of The Union and Board Director of APCAT.
"We have to find everyone with TB in our community and ensure that full spectrum of TB services are within reach of the person. As tobacco smokers are many times more at risk of TB (and several other deadly diseases), government must implement comprehensive tobacco control policies as per the WHO recommendations. These include higher taxes and prices on tobacco products, effective ban on all forms of tobacco advertising, promotion and sponsorship, increasing pictorial health warning on tobacco packs to over 90% size, complete ban of smoking in public places and workplaces, among others. When we do TB budget allocation at village level then we also need to couple it with budget allocation for full range of evidence-based tobacco control," added Dr Bam.
If we are to end TB by 2030, we need urgent and stronger collaborative actions so that while we scale up TB prevention, diagnosis, treatment and care services to all those who need it, we also reduce (and eventually eliminate) TB risk factors, such as tobacco, alcohol, and undernourishment, prevent and reduce NCDs, among other vital steps to strengthen health systems.
Shobha Shukla, Bobby Ramakant - CNS (Citizen News Service)
(Shobha Shukla and Bobby Ramakant are part of the editorial team at CNS. Follow them on Twitter @Shobha1Shukla or @BobbyRamakant)
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