The initiative was inaugurated at a side event of the 16th ASEAN Health Ministers Meeting (AHMM), where government leaders from ASEAN member states gathered.

The opening remarks were given by H.E Dr. Bounfeng Phoummalaysith, Minister of Health of the Lao PDR, while attendees included His Excellency Dr Teodoro Herbosa, the incoming Stop TB Partnership Board Chairman; Dr Anna Marie Celina, Director IV, Department of Health Disease Prevention and Control Bureau, Philippines; other ASEAN delegations; as well as Stop TB Partnership leaders.

The leaders came together to improve understanding of TB and pandemic preparedness across ASEAN, enhance stakeholder cooperation, and strengthen nations’ capacity to address airborne respiratory infections.

AIDP is supported by the United States Agency for International Development (USAID) and implemented by Stop TB Partnership and Stop TB Partnership Indonesia (STPI), a non-governmental organization that works towards the elimination of TB. The platform is endorsed by the ASEAN member states.

More than 2.4 million people across ASEAN are estimated to be affected by TB, based on the Global TB Report 2023. Five ASEAN countries (Indonesia, Myanmar, Philippines, Thailand and Vietnam) are on the World Health Organization (WHO) high burden TB list. Furthermore, the Covid-19 pandemic had devastated national TB prevention and treatment programs as personnel and resources were redirected from TB to Covid-19, leading to an estimated increase of almost half a million additional deaths of TB from 2020 to 2022.

In his welcome remarks, His Excellency Dr Teodoro Herbosa, the incoming Stop TB Partnership Board Chairman, said, “Our president Ferdinand Marcos Junior and our department of foreign affairs have given their approval for me to chair the Stop TB Partnership, which places an immense sense of responsibility on me personally and to the Philippines. I am committed to champion this cause and to tirelessly support impactful solutions not only for my country but the ASEAN region. The Philippines is still among the top eight countries with a high TB burden, but we are also making significant strides in TB control. One thing we have learned during the pandemic is that a strong system against TB can be a significant asset in dealing with other airborne diseases — for example the Philippines began introducing the molecular rapid diagnostic tests for TB as early as 2012 and gradually expanded the laboratory network to make it the primary diagnostic tool by 2020 when the Covid-19 pandemic struck. Investing in tackling one airborne infection such as TB is an investment into tackling all airborne infections.”

During a leadership dialogue at the event, Dr Anna Marie Celina, Director IV, Department of Health Disease Prevention and Control Bureau, Philippines, said, “The Philippines was one of the severely affected countries during the Covid-19 pandemic in terms of TB services disruption, and we saw a 37% decrease in TB case notification. But in 2022, we saw the highest case notification after the DOTS implementation, which is a perfect example of building back better. An integrated approach is necessary, including multi-stakeholder collaboration, involving the private sector, and investing in people who are key in providing essential services.”

In the Philippines, TB is one of the 10 leading causes of death. The five major risk factors are undernourishment, smoking, alcohol use disorders, diabetes and HIV. In 2022, an estimated 737,000 people in the country were diagnosed with TB, at a rate of 638 per 100,000 population. The WHO’s 2023 Global TB Report estimates 106 Filipinos die of TB every day.

The Philippines Health Secretary Ted Herbosa has announced his commitment to have the Philippines removed from the top 10 list of countries with the highest number of TB cases by the end of his term, which echoes the Philippines President Marcos Jr’s directive to focus efforts on combating the alarming rise of TB and HIV/AIDS.

Aiming to enhance cooperation to combat airborne respiratory infections, the AIDP will work together with ASEAN member states and key global organizations to agree upon policies and methodologies, as well as exchange learnings, use of infrastructure, platform technology and manpower to create surge capacity for TB cases and enhance pandemic preparedness.

Prof Tjandra Yoga Aditama MD, Stop TB Partnership Indonesia Senior Advisor and Airborne Infection Defense Platform (AIDP) Project Lead said, “The high death toll from the Covid-19 pandemic showed that the world was not prepared to combat the pandemic. In addition to the loss of human life, Covid-19 also severely impacted TB prevention, access, and treatment programs. The condition of tuberculosis (TB) in ASEAN is quite concerning, with many countries in the region still facing significant challenges in controlling and managing TB. This demonstrates the importance of working with ASEAN to strengthen the TB response system to not only create surge capacity for TB cases but also enhance pandemic preparedness.”

Preceded by conducting a landscape assessment, the AIDP will focus on strengthening pandemic and TB responses in each ASEAN country, including at the community and primary care levels. This will be done by enhancing existing healthcare infrastructure to improve detection, treatment, and prevention. It will also include leveraging platform technologies that have developed since the Covid-19 pandemic, including portable digital X-rays that enable testing to be done locally without the need for people to travel to hospitals or clinics, rapid molecular diagnostic platform technologies, and real-time digital surveillance tools. These various TB preparedness measures will be beneficial in facing a future pandemic, which is highly likely to be an airborne infectious disease.

Dr Suvanand Sahu, Deputy Executive Director, Stop TB Partnership, said, “The first phase in the Airborne Infection Defence Platform (AIDP) project will improve understanding by carrying out a landscape assessment across 10 ASEAN countries. This will outline the current capacities of each country to respond to TB and future airborne pandemics and recommend actions to achieve better pandemic preparedness. Following this, our second phase will support community-based and primary health care activities and initiatives to strengthen the preparedness capacity of TB responses across ASEAN to better address airborne respiratory infections or pandemics. We would like to thank USAID for their continued commitment to tackling TB around the world, particularly in the ASEAN region, whose efforts have culminated in AIDP. We would also like to thank the Govt. of Lao PDR for their leadership in convening the first meeting on AIDP.”

TB has a high mortality rate of almost 15%, compared to Covid-19, which stands at 3.5%. Research by Hogan et al. (2020) showed that TB prevention and treatment was significantly affected during the Covid-19 pandemic, where TB case detection decreased, household transmission of TB increased, BCG vaccination rates dropped, and access to TB drugs and testing declined.

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