LITTLEROCK, California — Tuberculosis (TB) is one of the most pervasive diseases in the world, leading to over 10 million sick and 1 million deaths annually. It is widely preventable and treatable, but less developed countries still suffer from the bacterial disease. COVID-19 has only made the battle harder.
The number of new TB cases increased by nearly 4.5% from 2020 to 2021. Elimination progress made prior to 2019 stalled or reversed because of the pandemic. With global focus diverted to COVID-19, TB spread with less detection and stronger drug resistance.
TB is most common in Southeast Asia—notably, Myanmar, Indonesia, the Philippines and Thailand. Using technological innovation, fighting Tuberculosis in Southeast Asia is underway again with renewed efforts.
After India, Indonesia has the 2nd highest burden of TB cases. TB is the number one cause of death among many diseases. Multiple agencies, including WHO and Indonesia’s Ministry of Health (MoH), stress the need for identifying and treating latent TB infection in Indonesia. The groups who take priority in screening are those with HIV/AIDS, household contacts and people considered high-risk.
Joining President Joko Widodo in 2020, Fullerton Health Indonesia staff screened workers at 12 factories in West Java at an Elimination of Tuberculosis 2030 event. The launched event follows Fullerton Health’s activities as an implemented partner to cover up to 150,000 people at risk, including populations residing at boarding schools and prisons.
WHO suggested in 2021 the use of computer-aided diagnosis (CAD) software, such as Lunit INSIGHT CXR, to perform screenings for older adolescents and adults without human readers. Lunit INSIGHT CXR is nearly 99% accurate in detecting abnormalities in chest X-ray images and speeds up the diagnostic process. An AI health care course was held in Indonesia in 2022, offering on-site training and the opportunity for health care officials to experience the Lunit AI screening process.
Like Indonesia, the Philippines has experienced an increase in TB cases and deaths, with over 370,000 TB cases recorded by the Department of Health (DOH) in 2022.
However, there is progress in the fight against Tuberculosis in Southeast Asia in the Philippines. Philippine Business for Social Progress (PBSP) is an NGO that is working to maintain a project called Advancing Client-centered Care and Expanding Sustainable Services for TB (or ACCESS TB). ACCESS TB is an accessible means of medical services that can tackle “drug-susceptible and multidrug-resistant TB (MDR-TB) cases.”
Close to 15,000 cases of MDR-TB were notified by ACCESS TB. The project ultimately treated more than 428,000 cases of TB out of 503,845 reported, reducing both frequency and mortality from 2021 to 2022.
Repurposing established COVID-19 infrastructure or networks is providing additional help. From containment to testing, the Global Fund’s COVID-19 Response Mechanism (C19RM) grant offers digital tools to improve the detection of COVID-19 and TB in high-burden areas. Having a support system and local manufacturing readily available for health crises makes a difference.
TB kills nearly 40 people daily in Thailand, but 2021 saw over a 10% decrease in TB cases and an 80% increase in treatment. Fujifilm’s aim is to help Thailand achieve its goal of providing 90% of TB treatment coverage by 2025.
The camera film giant, Fujifilm, has historically been involved in the medical world. After all, they created the first digital diagnostic X-ray imagery. Fujifilm now offers its x-ray device FDRAir and medical AI REiLI. To illustrate, the FDRAir is light at only 3.5 kilograms and can be stored in backpacks to take to rural areas like Chiang Rai and outreach centers. The ultra-light portable device alongside REiLi brings the latest tech to TB screening for those who need it most.
“We have recently launched our global campaign “NEVER STOP” that reinforces our commitment to assist medical professionals and improve the TB situation in Thailand,” said Yuto Kumagai, Assistant to the Managing Director of FUJIFILM (Thailand).
With a population of predominantly lower-middle class, Myanmar is a prime target of TB. According to Stop TB Partnership, undernourishment and close-quarter living, such as in slums, put these impoverished populations at risk. Myanmar made commendable progress in treating nearly 90% of people diagnosed with TB as of 2020 to meet the Global Plan to End TB 100% target.
The only country in Southeast Asia to reach WHO’s Sustainable Development Goal (SDG) of TB case reduction by the 2020 deadline is Myanmar. The goal was part of WHO’s End TB Strategy. Starting from 2015 till 2020, the country reduced incident rates by 20%. Myanmar reached this goal by using new diagnostic tools like AI, spending more to strengthen public health systems, and expanding TB care in public–private sectors.
At clinics around Myanmar, 21 cases of TB were rapidly detected (< one minute) with the AI screening tool qXR. The AI improved overall treatment outcomes in patients in 2021, according to one clinic’s primary physician, Dr. Hmwe Thazin Myint. Acquiring qXR resulted from a joint partnership with PATH, Stop TB Initiative TB REACH WAVE 7 and the Myanmar Medical Association. Where there is a lack of radiologists or doctors in Myanmar, AI can fill the gap and prevent missing cases or stalling treatment. Furthermore, TB REACH WAVE 7 employs public-private collaboration, motivating patients to complete treatment where comfortable and accessible. As a result, the total TB case notifications increased by 20% in a year (2018-2019).
With more innovative tools and a new vaccine in development, Tuberculosis in Southeast Asia being defeated by 2030 is plausible. Alongside united global efforts and government commitment, it can become a reality.
– Clare Calzada