Tuberculosis in Indonesia : Epidemic Projections and Opportunities to Accelerate Control

Indonesia is the third largest contributor to the global tuberculosis (TB) burden and among the top twenty countries in the world for TB-HIV (human immunodeficiency virus) coinfection, and multidrug-resistant TB (MDR-TB). In addition to the significant toll of TB to health and human capital, the economic burden of TB is substantial. Controlling TB in Indonesia will require not only that the Government of Indonesia (GOI) spend more on TB but that it spend it better. This means that decisions on which interventions or programs to prioritize and how best to implement them will be critical to maximizing health outcomes. Projections indicate that TB incidence will remain relatively stagnant under status quo spending and that there is limited scope for improving allocative efficiency. Following a request for technical assistance from the Government of Indonesia (GOI) on how to make available TB resources go further, especially in a context of shrinking external funding, consultations were held with program managers and experts in the National TB Program, the Ministry of Health, and the Ministry of Finance. Optima TB is a mathematical optimization model that informs policy makers and program managers on how to allocate the available resources across TB programs to maximize impact. This report covers the findings from an Optima TB analysis conducted in Indonesia as of September 2020