Asian doctors seek wider, more proactive TB testing

BANGKOK, Thailand — Doctors from Indonesia and Pakistan have called on nations to expand their testing capabilities for tuberculosis (TB) and make efforts to diagnose the disease more proactively, particularly for low and middle-income countries (LMICs).

“The new technologies, the new innovations are only found in big cities and in the rich countries where they do not have enough TB cases but they have all the technology,” Universitas Indonesia respiratory medicine professor Erlina Burhan said at a panel during the Asia-Pacific International Roche Infectious Diseases Symposium (APAC-IRIDS) in Bangkok on Thursday.

“But, I think please also pay attention to provide these new technologies and innovations in diagnosis and treatment to the low and middle income countries,” she added.

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Indonesia is the second hardest-hit nation by tuberculosis, accounting for 10 percent of all cases worldwide, according to the latest Global Tuberculosis Report by the World Health Organization (WHO) in 2025.

For her part, Pakistani public health specialist and epidemiologist Razia Fatima likewise noted that, while experts around the globe had made progress in controlling tuberculosis, they have yet to improve on treating the disease when it is an inactive infection in an individual.

“[Tuberculosis control] has saved millions of lives, no doubt. But, it is largely reactive, I would say, because we intervene only after people become sick,” Fatima said, joining Burhan at the APAC-IRIDS panel via teleconference.

“To achieve the WHO End TB Strategy goals, we need to shift from TB control to TB elimination. And that requires a much stronger focus on prevention and equitable access to diagnostics,” Fatima added.

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Approved in 2014 and published in 2015, the WHO End TB Strategy aims to reduce TB incidence by 80 percent; and TB deaths by 90 percent.

Similar to Indonesia, Pakistan is among the countries most heavily burdened by tuberculosis with 6.3 percent of all global cases, the WHO further noted in its 2025 report.

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Data from the WHO showed that the estimated TB incidence rate in Indonesia was 382.2 cases per 100,000 population as of 2024; up from 328.7 cases per 100,000 population back in 2014, the year the End TB Strategy was approved.

Further, the data showed 125,625 deaths attributed to tuberculosis had been recorded in Indonesia in 2024; up from the 115,204 fatalities in 2014.

Meanwhile, Pakistan’s estimated TB incidence rate was 266.1 cases per 100,000 population in 2024; a slight drop from the 270.1 cases per 100,000 population in 2014.

Likewise, the number of estimated deaths caused by TB in Pakistan was 51,716 in 2024; somewhat down from 53,563 deaths in 2014.

Indonesia is an upper-middle income country, while Pakistan is a lower-middle income country, which means both nations are LMICs, according to data from the World Bank.

“We need to really expand TB infection testing so that we can identify individuals who are at risk,” Fatima stressed.

“Who are those people at risk? These are the household contacts who are living with an active TB case, children under five, people living with HIV (human immunodeficiency virus), and individuals with immunosuppressive conditions… those with diabetes, those who are undernourished, or those who are exposed to tobacco,” she added. /das

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