The spread of COVID-19 has a severe impact on health systems throughout the world. Although morbidity data is still being collected and analysed, it is known that the risk of death from COVID-19 is higher in individuals with diabetes, heart disease, and chronic lung disease (including asthma and TB). The link between COVID-19 and other disease threats underscores that other essential health services still need to be implemented as part of responding to this pandemic. For example, immunisation and prevention and control of infectious diseases such as TB.
TB services will be impacted at various levels as resources are diverted to COVID-19. High TB burden countries like Indonesia must do everything they can to protect TB patients and survivors from COVID-19 exposure. If TB patients and survivors develop COVID-19 symptoms, they must be tested immediately and hospitalised, if indicated.
Given the dire need to protect TB Patients, on 14 April, the House of Representatives of Indonesia conducted a virtual hearing with the Ministry of Health, specifically discussing TB and Dengue in time of COVID-19. The meeting resulted in several action points, among others:
House of Representatives urged the Indonesian Ministry of Health to take steps to accelerate the prevention and control of Dengue Hemorrhagic Fever (DHF) and Tuberculosis (TB) in the midst of COVID-19 pandemic
The House of Representatives urged the Indonesian Ministry of Health not to reallocate the budget and if possible increase the budget of TB and DHF in the 2020 State Budget in the midst of COVID-19 pandemic
House of Representatives urged the Indonesian Ministry of Health to massively improve management of TB, including MDR-TB, through strengthening health service, increasing the human resources capacity and intensifying the involvement of sub-national government
House of Representatives urged the Indonesian Ministry of Health to conduct mapping of TB and DHF as well as carrying out special interventions in areas that are high risk COVID-19 to prevent further spread of TB and DHF
House of Representatives urged the Indonesian Ministry of Health to guarantee availability of TB and DHF drugs, including MDR TB and other drugs, and ensuring access to health facilities throughout Indonesia
Also, the House of Representatives of Indonesia reminded that the attention to prevention and control of infectious diseases such as TB needs to be maintained during the COVID-19 pandemic, to avoid a situation similar to the Ebola outbreak in West Africa, where deaths from HIV / AIDS, TB and malaria were higher than those caused directly by Ebola (Global Fund, 2020).
The Ministry of Health of Indonesia has provided a Protocol on TB Services during the COVID-19 Pandemic Period. Stop TB Partnership Indonesia and other TB CSOs are currently developing a system to monitor the implementation of this TB Protocol. The purpose of this system is to understand the different aspects of prevention, management, planning, care, treatment and laboratory services for TB patients during the COVID-19 pandemic. The results will be used to influence the policy making process of the TB program.
The actions taken by the House of Representatives, Minister of Health, Stop TB Partnership Indonesia and CSOs has shown that Indonesia is making positive progress to make sure that TB Services are not disrupted in this time of pandemic. Hopefully, more countries will follow the lead.