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How One Country Is Turning the Tide Against an Ancient Killer

Indonesia’s Fight to Defeat Drug-Resistant Tuberculosis

By The Global Fund

January 22^nd, 2026

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On his coffee farm in rural East Java, Indonesia, Pak Jun developed a persistent cough. He was nauseous, dizzy and unable to eat. When his condition failed to improve, Pak Jun’s family took him to the local puskesmas, or health center, for a check-up.

Then the diagnosis of drug-resistant tuberculosis came: “I was shocked,” he says.

Person in a cap pruning a coffee plant with pruning shears, with coffee cherries visible. A building is in the background.

Pak Jun’s battle with TB is shared by many people across Indonesia – about 1 million people fall ill with the disease every year and the country has the second-highest TB burden in the world. Drug-resistant TB, a deadly strain of the disease that is difficult to diagnose and does not respond to first-line treatment, is a major threat. Without effective treatment, the disease is fatal, with many patients at risk of dying within a few months. Left unchecked, drug-resistant TB can spread within and beyond borders – posing a serious danger to millions of people across the globe.

Indonesia – once exclusively a recipient of Global Fund grants, and now also a donor to the Global Fund itself – is tackling this challenge head on. In 2024 and 2025 the country rolled out a country-wide initiative to reinforce the fight against drug-resistant TB, equipping over 460 local health centers to initiate treatment and dispense drug-resistant TB medication locally. Transitioning to 6-month regimens and bringing treatment and care closer to home has been a game-changer – creating a system that makes it easier for patients to begin and complete their treatment successfully.

A person wearing a headscarf and face mask examines a chest x-ray on a light board in a tiled room.

A healthcare worker in a hijab and mask takes a patient's blood pressure in a clinic. Another masked worker sits at a desk in the background.

Two people wearing face masks stand at a counter. One person in a white shirt holds blister packs of pills. Another person in a tan uniform and hijab stands beside them. A third person is visible through a window.

Previously, many people with drug-resistant TB had to travel for hours to reach regional hospitals in order to access in-patient care. Today, they can complete their treatment course at home. This not only reduces costs for the health system, but also alleviates the crushing financial burden faced by many people with drug-resistant TB. When people fall ill and are unable to work, the cost of treatment and travel to distant hospitals is out of reach.

Indonesia expands access to drug-resistant TB care. In 2 years, 464 rural health centers initiate treatment. Reference hospitals managing care increase by 43%. 80% of patients receive BPaL/M treatment, up from 17% in January 2024.

Indonesia has also rolled out a revolutionary drug-resistant TB treatment regimen called BPaL/M. Because this treatment lasts just 6 months – rather than 9-24 months like other treatments – and has fewer debilitating side effects, and fewer pills to take, patients are more likely to successfully complete their treatment and become well again.

Indonesia moved rapidly to expand access to BPaL/M. In January 2024, only 17% of eligible patients were receiving the new treatment; by December, coverage had surged to over 80% and continues to climb. While the Global Fund initially financed the rollout, Indonesia is now increasingly covering the costs itself.

The Global Fund has also supported access to BPaL/M in several other countries, including Viet Nam and the Philippines, and by 2025, more than 85% of eligible TB patients in Pakistan and Bangladesh were receiving this lifesaving regimen.

A person's hand offers two white pills to another person over a wooden table. A water bottle and container of liquid are also on the table.

Pak Jun lives within the coverage area of one of the smaller, local clinics.

He and his family live on a farmstead tucked away in the tropical rainforest of Mount Argopuro. Banana, mango and papaya trees dot the property, and the family grows ginger, too. The coffee crop is their main source of income. The farm is unreachable by car – only a motorbike can wind down the steep dirt road to reach Pak Jun’s door.

“This disease that I have is dangerous,” says Pak Jun. “So I don't want to infect other people. Especially my kids. I even wear a mask when I sleep.”

Pak Jun became a coffee farmer 25 years ago; like many young people, he and his wife were seeking a peaceful environment to raise a family.

Today, severely weakened by drug-resistant TB and the side effects of his medication, Pak Jun has been unable to work.

“I have to cut the grass myself, because if I take him to work even for a little while, his body aches all over,” says his wife, Ibu Warda. “When I see him in pain, my mind goes everywhere. I worry.”

In Indonesia, patients diagnosed with drug-resistant TB and enrolled on treatment qualify for an “enabler payment” – a monthly allowance that is given over the duration of their treatment to help pay for food and cover transportation costs to and from the health clinic to collect their medicine and undergo follow-up testing. The Global Fund covers these payments – a true lifeline for so many families – in all of the 514 districts across the country.

As part of Indonesia’s effort to extend the reach of health services to people like Pak Jun, who live in some of the most remote locations of the country, a specialized health workforce – called TB cadres and case managers – have also been hired to provide drug-resistant TB care. They offer essential support to people as they complete a difficult course of treatment.

“We are here to motivate patients,” says Gufron, a TB cadre. “So we can support the patients in their recovery.”

Gufron video calls Pak Jun every day and ensures he takes his medication, logs any symptoms, and then reports to the district level, where the data is entered into a national database. Gufron also visits Pak Jun and his family in-person twice a month.

Three people wearing masks stand on a porch. One person shakes hands with an older person seated at a table. A person in a hijab stands to the right.

Four people stand in front of a yellow building with a window. From left to right, a man in a gray shirt, an older man in a white shirt and sarong, a woman in a hijab and floral dress, and a young man in a black shirt.

Indonesia’s comprehensive approach to diagnosis, treatment and care of drug-resistant TB is a cornerstone of the country’s health transformation strategy and promises to have a real and tangible impact in the fight against the deadly disease.

And Indonesia’s dual role in the Global Fund partnership – as both an implementing partner and a donor – is a powerful example of how long-term multilateral investments can reinforce national leadership. Since 2002, the partnership has saved an estimated 4.8 million lives in Indonesia.

Countries including Indonesia are progressively increasing spending on health and moving away from donor financing. In Indonesia, transition planning is led by the Ministry of Health and aligned with national health insurance (JKN), and includes collaboration with international development banks and one of the largest Global Fund-facilitated Debt2Health agreements to date. Within this context, Global Fund support increasingly complements domestic resources rather than financing core program functions.

Cityscape with tall buildings under a cloudy sky, viewed from behind low buildings with red-tiled roofs and a white wall.

Continued international and domestic investments in health are more critical than ever to end TB, AIDS and malaria. Indonesia is emerging as a global health leader – charting a path toward sustainable, domestically driven solutions in the fight against TB and beyond.

For Pak Jun, these efforts have saved his life.

Footnotes

Written by Margo Mombrinie. Photography by Vincent Becker. With special thanks to the Indonesia Country Coordinating Mechanism, Yabhysa Care and the Jember Health Office.

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FootNotes

Written by Margo Mombrinie. Photography by Vincent Becker. With special thanks to the Indonesia Country Coordinating Mechanism, Yabhysa Care and the Jember Health Office.

Wie es einem Land gelingt, das Blatt gegen einen alten Killer zu wenden

How One Country Is Turning the Tide Against an Ancient Killer

Indonesia’s Fight to Defeat Drug-Resistant Tuberculosis

FootNotes

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September 8^th, 2025

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FootNotes

Bekämpfung der medikamentenresistenten Tuberkulose in Indonesien

La lutte de l’Indonésie pour mettre fin à la tuberculose pharmacorésistante

October 27th, 2025

October 27th, 2025

September 8th, 2025

September 8th, 2025

October 27^th, 2025

October 27^th, 2025

September 8^th, 2025

September 8^th, 2025