Indonesia

TB data for 2015 were combined with cost data using a simple type of cost-benefit analysis in a decision tree model to show the economic burden under different scenarios. In Indonesia, there were an estimated 1, 017,378 new active TB cases in 2015, including multidrug-resistant TB. It is estimated that 417,976 of these cases would be treated and cured, 160,830 would be unsuccessfully treated and would die, 131,571 would be untreated and would achieve cure spontaneously, and 307,000 would be untreated and would die. The total economic burden related to treated and untreated cases would be approximately US$6.9 billion. Loss of productivity due to premature death would be by far the largest element, comprising US$6.0 billion (discounted), which represents 86.6% of the total cost. Loss of productivity due to illness would be US$700 million (10.1%), provider medical costs US$156 million (2.2%), and direct non-medical costs incurred by patients and their households US$74 million (1.1%). The economic burden of TB in Indonesia is extremely high. Detecting and treating more cases would result not only in major reductions in suffering but also in economic savings to society.

Abstract Background: One of the main goals of the post-2015 global tuberculosis (TB) strategy is that no families affected by TB face catastrophic costs. We revised an existing TB patient cost measurement tool to specifically also measure multi-drug resistant (MDR) TB patients’ costs and applied it in Ethiopia, Indonesia and Kazakhstan.

Drawing on their experience in a range of developing countries, including 20 years of long-term experience in Afghanistan, Cambodia, Indonesia, and the Philippines, Steve and Cathy Solter identify 10 important lessons about assisting ministries of health Pursuing true country ownership for effective programs requires a long-term approach involving persistence, patience, keen understanding of counterparts’ perspective, deference, building of trust, focus on priorities, technical competence, and sustained optimism.

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