The Indonesia tuberculosis control program faces several challenges including limited and low quality health facilities and services, dependency on donors for funding, and increased susceptibility to TB due to other health problems. Key areas of research needed include identifying host protection against TB, developing new diagnostic tools and treatment duration, discovering new drug preparations, and evaluating factors that cause delays in diagnosis and treatment. Drug resistance is also a growing challenge that Indonesia is piloting projects to address.

2. The Challenges of the Indonesia tuberculosis control program
1. The optimization of health facilities TB services, including limited quality and quantity of health facilities
TB services health workers
2. The optimization of the management and distribution of anti tuberculosis drugs
3. Dependency of most of the funding on donors.
4. Compliance of healthcare providers with national TB control guidelines
5. National Health Insurance System Coverage
6. Economic Growth Disparities
7. Susceptibility to TB infection due to the increases of other health problems/underlying diseases.

3. TB Research topics due to the current challenges and condition of TB
control program:
a. Basic research :
i. Research related to the identification of host protection systems against
tuberculosis.
ii.Research related to latent infection and latency (latency period, reaction time,
response time from tuberculosis infection).
iii.Research related to tuberculosis/MDR TB genotype and phenotype markers.
iv.Research to develop a time model for tuberculosis therapy (in animals).

4. a. Epidemiology and public health research
i. Epidemiological research to measure the tuberculosis burden precisely
ii.Determination of the role of social factors in society on the risk of
tuberculosis infection/transmission
iii.Research to increase patient and family/environment recognition and
participation in tuberculosis control programs, disease burden, and medication
adherence

5. a. Diagnostic research and diagnostic tests
i. Research for the development of new diagnostic tools and methods for active
tuberculosis
ii.Development of a new method of testing OAT resistance
iii.Evaluation of the diagnostic pathway for active tuberculosis
iv.Develop various biomarkers for measuring indicators of successful
management of tuberculosis in different conditions and stages.

6. a. Drug development research
i. Research for the development of effective chemoprophylactic preventive
measures.
ii.Research to find therapy with optimal duration.
iii.Discovery of new, more effective OAT preparations.
iv.Research to increase understanding of pharmacokinetics and interactions of
OAT and second-line OAT with other chronic disease drugs, especially in TB-
hepatitis, TB-HIV, TB-DM, and others.

7. a. Health services research
i. Evaluation and investigation of all factors causing delays in diagnosis and treatment
ii. Develop a tuberculosis financing model and tuberculosis-related health service resources.
iii. Develop the role of patients, patient groups, and the environment/community in finding tuberculosis
cases.
iv. Develop an integrated model for tuberculosis and HIV infection control programs.
v. Research the need to develop the quality and quantity of human resources in tuberculosis-related health
services.
b. Vaccine development research
i. New vaccine development and trial.

8. • In addition, drug resistance (MDR/XDR TB) is a growing challenge for tuberculosis control
programs. In this regard, the National Tuberculosis Control Program in Indonesia 2009 has
launched a pilot project, Programmatic Management of Drug-Resistant TB Treatment (PMDT),
and is currently carrying out a pilot project GenExpert to increase capacity and capability for
diagnosis and therapy.