Integrated care for tuberculosis (TB) and diabetes mellitus (DM) comorbidity in Asian countries: health system challenges and opportunities

Overview

The dual burden of tuberculosis (TB) and diabetes mellitus (DM) has become a major global public health concern and a critical public health challenge in low- and middle-income countries (LMICs). The high prevalence of TB and DM independently in Bangladesh, China, India, Indonesia, Nepal and Philippines underscores the potential high prevalence of TB–DM comorbidity, and face public health challenges due to the emergence of comorbidity of TB with DM.

The burden of comorbidity is compounded by health system constraints leading to limited prevention and diagnostic facilities, limited access to care and completion of treatment. Addressing this growing threat of TB–DM comorbidity would require a multifaceted approach and collaboration across government departments, the private sector and professional bodies. Across the countries included in this policy brief, a readjustment or reorganization of the health system was recognized as a necessary component for accelerating efforts at developing an integrated primary health care system for the prevention and control of TB–DM comorbidity. There would be a need to re-engineer how these two independent programmes can be meshed into a singular programme, requiring a rigorous evaluation of health systems, and also a need for rigorous evaluation of the contextual and health system-level complexities that will enable or hinder this initiative. There also is a need to strengthen community awareness and public education for the prevention and management of TB–DM, and overall develop context-relevant strategies to integrate TB–DM services for better prevention, diagnosis and management of the diseases.

Download the APO latest policy brief on Integrated care TB and DM comorbidity in Asian countries for a comprehensive overview and detailed policy recommendations to strengthen integrated care for TB–DM.

How to Cite this publication

Abdullah A S, Rawal L B, Bhattarai S, Silva M E, Koya S F, Choudhury S R, et al. Integrated care for tuberculosis (TB) and diabetes mellitus (DM) comorbidity in Asian countries: health system challenges and opportunities. New Delhi: World Health Organization Regional Office for South-East Asia; 2022.