Indonesia’s national TB programme is making significant progress responding to the threat of DR-TB. In 2017, Indonesia achieved 100 percent national coverage by establishing 360 DR-TB treatment facilities and 2,300 DR-TB satellite sites across all 34 provinces.
In 2020, the World Health Organization recommended an all-oral treatment for DR-TB, which lasts for around 9–11 months. This new regimen is shorter, easier to administer and more effective than the conventional DR-TB treatment, which can take up to 24 months and also requires daily injections.
But the new treatment regimen remains a challenge for many patients. On top of financial hardship, the treatment can have a range of side effects, including nausea, drowsiness, depression, psychosis, kidney impairment and hearing loss.
Much remains to be done. From January to September 2022, there were 8,042 patients with confirmed cases of DR-TB, and approximately only 54 percent of them received treatment,[4] likely because of the barriers posed by the range of economic and social challenges associated with DR-TB.
The Access and Delivery Partnership (ADP) has contributed to the TB response efforts in Indonesia, especially through its support to set up surveillance systems that ensure the safe scale-up of new TB medicines.
Between 2014 and 2016, ADP supported the national TB programme, the National Drug and Food Control Agency and public hospitals to enhance their ability to detect and properly manage unwanted side effects of bedaquiline, a new medicine that is part of the shorter treatment regimen for DR-TB. This included the training of nearly 200 health care providers and pharmacists for ‘active safety monitoring’, which is the active and systematic clinical and laboratory assessment of patients while on treatment, to detect, manage and report suspected or confirmed adverse drug reactions.