Tuberkulosis di Indonesia

About tuberculosis in Indonesia

Indonesia carries the second-largest tuberculosis (TB) burden in the world, with an estimated 1.09 million new cases each year. TB is a disease of poverty: it concentrates among working-age adults and the poorest communities, and it remains both preventable and curable when care reaches people early.

ARC Institute looks at TB from two complementary angles. The demand-side analysis uses the BPJS Kesehatan Sample Data for 2015 to 2024 to describe how people with TB actually use the National Health Insurance scheme (JKN): who is reached, how care moves from primary clinics to hospitals, treatment continuity, drug-resistant and TB-HIV burden, cost, and equity of access. The supply-side analysis turns to the system itself, asking whether Indonesia has the specialists, laboratories, isolation facilities, medicines, information systems, and financing to diagnose and treat TB, and how unevenly that capacity is spread across districts.

The two reports answer different questions and are read together. Demand shows where care reaches people and where it falls short. Supply shows whether the underlying capacity exists to close those gaps. Both describe the TB that is recorded in JKN and the health system, not the full national TB burden, since much TB diagnosis and treatment runs through the vertical public TB programme outside JKN claims.

Key findings

• TB served through JKN follows an inverse-care gradient: the poorest subsidised members have the lowest served rate (about 9.75 per 1,000) even though TB is a disease of poverty, while self-paying members have the highest (about 28.3 per 1,000, roughly 2.9 times higher), a signal of weaker case-finding among the poor.
• Treatment continuity is fragile in the claims record: only about 47 percent of eligible patients show sustained TB engagement for six months or more, and about 31 percent drop out early, a proxy for loss to follow-up that warrants coordination between JKN and the public TB programme.
• Drug-resistant TB is rare in claims but devastating per case: median cost is about Rp 10.6 million per patient (roughly 5.4 times drug-sensitive TB), and three in four such patients are hospitalised.
• TB care is costly and highly concentrated: the top 10 percent of patients account for about 47 percent of hospital spending, and much of the burden sits in other conditions and complications rather than TB services alone.
• The specialist base is thin: Indonesia has only 0.516 pulmonologists per 100,000 people (about one per 746 incident TB cases), so the burden rests on internists and general practitioners rather than dedicated lung specialists.
• Infection-control infrastructure is sparse and centralised: 71.4 percent of districts have no airborne-isolation (negative-pressure) capacity, 37.9 percent have no microbiology laboratory for molecular diagnosis, and only 96 of 3,275 hospitals (2.9 percent) have complete TB capability.

Choose an analysis

Two reports examine tuberculosis from opposite sides of the same system. Start with the one that matches your question, or read both.