0 Indonesian Health Officials Say TB Treatment Won’t Be Forced

Despite the low adherence to the rigorous and lengthy treatment regime to cure tuberculosis, Indonesian health authorities have no plan to force people to stick to their treatment plans. “We can’t force people when they have suffered enough,” Health Minister Nafsiah Mboi said after a meeting with the Joint External TB Monitoring Mission (JEMM) on Thursday. Although admitting Indonesia has problems in convincing TB patients to stay on their treatment regimens, Nafsiah said the number of people with interrupted TB treatment in Indonesia remained relatively low compared to other countries. 

Prof. Donald Enarson, a senior adviser at the International Union Against Tuberculosis and Lung Disease, shared the same sentiment. He said that while convincing the patients to finish their medication was important, coercing them to stick to their treatment with a binding regulation was unnecessary. “Coercing patients is not the answer because they have suffered enough, their money, their health. Let’s not add to their burden and let’s stop blaming the patients,” he said. 

Indonesia provides free care for people who have been diagnosed with TB. This also applies to those who have developed a resistance to TB drugs. A patient suffering from active TB needs to take a six-month course of treatment that cannot be interrupted, otherwise the patient could develop multidrug-resistant tuberculosis (MDR TB), which is much more expensive and difficult to treat. Enarson said many people decided to stop their treatment, even though it was accessible for free, because they still needed to spend money on transportation to and from treatment centers. 

Khanchit Limpakarnjanarat, the World Health Organization representative to Indonesia, said the treatment drop-out rate for TB was a global problem, which was a reason for serious concern because of the growing number of MDR TB cases. “Sometimes people stop their therapy because of inconvenience, maybe because their house was far from the health center,” he said. The ministry’s director general of disease control and environmental health, Tjandra Yoga Aditama, said that even though Indonesia is still listed as a high-burden country when it comes to TB, the treatment adherence had become slightly higher. 

“In 2012 there were less than 5 percent of TB patients who stopped their treatment; in 2011 the figure was 8 percent, so it’s getting better,” he said. The ministry estimated that there are 450,000 new active TB cases in Indonesia every year, putting the country behind only India, China and South Africa in terms of TB prevalence. The ministry also reported that TB kills at least 65,000 Indonesian annually, making it the number one killer among communicable diseases in Indonesia. Tjandra said that only about 65 percent of TB patients were covered by the government’s program. 

“The rest are taken care of by nongovernmental organizations and some others seek medical help privately,” he said. He said even though many people decided to stop their treatment program before six months, after two months of treatment they would not be contagious anymore.

source : the jakarta globe