Brief Summary
This consultation assessed the landscape and needs for social protection among people affected by drug-resistant tuberculosis (TBC-RO) in Indonesia, aiming to inform policy advocacy for the development of inclusive and adaptive social protection (SP) schemes tailored to this vulnerable group.
TBC-RO is a severe form of tuberculosis requiring long-term and complex treatment, placing significant financial and psychosocial burdens on affected individuals and households. Despite available medical support through Indonesia’s national health insurance (JKN), non-medical costs such as transportation, nutritional supplements, and income loss remain major barriers to treatment adherence and successful recovery.
Conducted in 2024, this mixed-method study was commissioned to generate evidence to support the Indonesian government’s emerging commitment—articulated during a Presidential directive in July 2023—to provide direct social support beyond the existing Family Hope Program (PKH). The study built on the WHO–ILO framework for social protection for TB-affected populations, focusing on mapping the current SP landscape, identifying patient needs, estimating ideal benefit levels, and exploring policy implementation challenges at both national and subnational levels.
Through literature reviews, secondary data analysis, and qualitative fieldwork in three districts (Deli Serdang, Sidoarjo, Makassar) and Jakarta, the study revealed critical gaps in protection. Key findings highlighted significant financial hardship across all treatment phases, especially during the intensive phase. Patients reported selling assets or borrowing money, while caregivers faced lost productivity and stigma. Urban patients prioritized nutrition, while rural patients emphasized transportation support.
Cost simulations showed that a modest but well-targeted SP scheme—covering transport, food, and supplements—would require Rp1.25–1.4 million per patient per month. While donor-funded programs like the Global Fund’s TBC Enabler provide temporary relief, long-term sustainability hinges on government ownership and interministerial coordination.
This consultation underscored the feasibility and urgency of a targeted SP program for TBC-RO, offering actionable insights for national policymakers, including the Ministry of Social Affairs, Ministry of Health, and the Coordinating Ministry for Human Development and Cultural Affairs. It recommends advancing multi-sector collaboration and leveraging existing social protection infrastructure to ensure that no patient is left behind in Indonesia’s journey toward TB elimination.