Catapulting funding crisis into opportunity by getting on track to end TB and tobacco use

"Governments can also levy similar taxes on alcohol, sweetened sugary drinks, or junk fast food - all of which is a major pushback for public health, as it increases the risk of preventable deadly diseases," rightly said Dr Bam.

By raising taxes on products that are proven to increase the risk of deadly diseases, governments can get more financial resources to invest into public health. More importantly, raising such taxes would deter users to consume harmful products and dissuade those who are not yet consumers of unhealthy diets and drinks.

For every US$ 1 invested in TB control, return on investment is US$ 46

An important 2023 study shows that for every US$ 1 invested in science- and evidence-based TB control, the return on investment is US$ 46.

When hit with funding crises at several levels, does it not make a lot of sense to invest domestic resources in fully funding the domestic fight to end TB? If governments find ALL people with TB with best of screening and diagnostic tools, put them on the latest treatment regimens, then they would prevent TB too, reduce human suffering and untimely deaths. TB preventive therapy as well as addressing risk factors for TB is equally important.

"Stronger implementation of evidence-based tobacco control measures also has a positive impact on TB response as well as other health programmes, such as those addressing cardiovascular diseases, diabetes and other non-communicable diseases," said Dr Bam.

Double trouble: tobacco and TB

Dr Putu Ayu Swandewi Astuti, Coordinator of Undergraduate Public Health Study Programme, Udayana University, said that tobacco use is the biggest risk factor for TB, as per the latest WHO Global TB Report 2024. Tobacco use was the risk factor for almost 150,000 people with TB disease in 2023 in Indonesia (one-fifth of the total number of TB patients notified in the same year in Indonesia). Undernutrition ranked 2ndbiggest TB risk factor in Indonesia with 84,000 people with TB disease notified in 2023. Diabetes, HIV and alcohol were the next three big risk factors for TB in the country.

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