Economic and Health; the double burden of Tuberculosis in Indonesia.

What can the government and private sectors do to tackle this problem?

Economic and Health; the double burden of Tuberculosis in Indonesia. Photo: Unsplash

Diana (38) – not her real name – is one of the persons who experiences financial loss during the time when she was diagnosed with Tuberculosis (TB). At 24, she was diagnosed with tuberculosis and after 2 years receiving treatment for her Drug Sensitive TB (DS TB) it does not seem to have significantly improved. She still suffered from extreme cough and sometimes blood cough. As the 2012 year started, then she found out that she was in the second stage of TB (DR TB). From the time she was diagnosed, during her treatment, and after she was cured, she kept receiving stigma that led to her career loss. The story begins when she was showing symptoms like blood cough in her office and her co-worker found out and report it to the supervisor. After she told the supervisor that she was suffering from TB and need to take daily medicine as her treatment, her supervisor started to isolate her and take her out from the strategic position. During the lunch break, no one wants to sit around her, and everyone stops talking when she makes an appearance.

Diana is just one of the cases that experienced by many TB patients. It has come to a realization that people affected by the Tuberculosis are less likely to stay in jobs and more likely to experience discrimination. They are 20 times more likely to end up in poverty and some of them even end up in divorce. In general, the cost for TB patients was atributed by travel and nutritional supplementations costs, but losing both job and income after people was diagnosed from TB is another issue that need to addressed. According to the research that was held, the poor household suffered more than non-poor households. In 2017, the Faculty of Medicine, Gajah Mada University conducted a study on the total economic burden due to TB which was estimated around Rp. 92 trillion that was from;
1. Loss of productivity due to premature death of workers
2. Loss of productivity due to disability in workers experiencing TB
3. TB-related health service costs
4. TB related household expenses

In particular, the impact of TB in the workplace will also contribute to (1) lowering performance and productivity, (2) Increase the cost of medical treatment, recruitment and others, (3) Increased lost hours and days of work, (4) Resulting in potential loss of skilled and experienced workers.

Indonesia is a country with a large population, currently Indonesia's population is 268 million and around 181 million are in the workforce. The workforce is a population of productive age aged 15-64 years who are ready to work (BPS, 2020). Almost half of the people affected by TB in Indonesia belong to the productive age. Also, the high prevalence of TB in Indonesia will affect the credibility of Indonesia as a country that attracts investment from foreign investors.

Investing in TB services means investing for the future generation and will lead to economic stability. Capital loss due to suffering from TB could be prevented if government and the private sectors who provide work or the employer could go hand-in-hand in tackling this situation.

Investing in TB services means investing for the future generation and will lead to economic stability


With the demographic bonus that Indonesia will reap, it is crucial to ensure the quality of its human resources so the country could take full advantage of the additional numbers in its population. Many things could be implemented to ease the economic burden for the people with TB, one of the way is create a close collaboration with employer and company to protect people affected by TB, such as:
1. Companies should protect employee rights by avoiding discrimination, increase their chance to have healthcare access, and give social and moral support for the affected employee
2. Ensure the safeties of work environment by providing proper education regarding TB and how to prevent it, applying the regulation that enable people affected by TB to receive treatment and still making contribution, and creating healthy environment through better ventilation in a work space so people could have better air circulation

Firing patients who are sick from their job due to efficiencies and putting them in such difficult situation that Healthcare is becoming a privilege exclusively for the wealthy. It shouldn’t be a punishment or crime for people to seek treatment. Their existence is not a crime. Country should ensure the equity of citizen’s rights to access healthcare. In addition, we should check our privileged status because when we have options, we’re in a position of privilege and we should use it to advocate and empower others to ensure there is no one left behind and Indonesia will be able to achieve its target for TB elimination in 2030.

Siva Anggita is a Director of Partnership at Youth Movement of Tuberculosis in Indonesia and post-graduate student at the School of Government and Public Policy Indonesia

You need to login to write a comment!