The Bhutanese Leading the way.
Bhutan has witnessed a concerning rise in infectious diseases, with new cases and deaths from tuberculosis (TB), HIV/AIDS, and malaria increasing compared to the previous years, according to the Ministry of Health’s Annual Health Bulletin 2025.
These three diseases are collectively known as Big Three Infectious Diseases (BTIDS). They consistently rank among the leading causes of infections and deaths each year, placing a considerable burden on the healthcare system.
The latest figures indicate not only a higher number of infections but also an increase in fatalities, highlighting the continuing public health challenge posed by these diseases in the country.
In 2024, a total of 920 TB cases were reported, highlighting comprehensive prevention and treatment strategies. According to the report, “Among these, 65 percent were cases of pulmonary TB, of which 552 were bacteriologically confirmed, and 19 were clinically diagnosed.”
Bacteriologically confirmed TB refers to cases that are verified in the laboratory, typically through tests like sputum smear microscopy, which detect the tuberculosis bacteria. Clinically diagnosed TB, however, is identified based on a patient’s symptoms, medical imaging, and a doctor’s assessment when lab confirmation is not available.
Additionally, 38 cases were identified as pulmonary TB relapses, while 17 cases involved relapse of extrapulmonary TB. Relapse cases are defined as patients who were previously treated for TB, declared cured or having completed treatment, but are now diagnosed with a recurrent episode of the disease.
This represents an increase from 864 TB cases in 2023, as recorded in the Annual Health Bulletin 2024.
Health officials emphasize that preventing tuberculosis depends largely on early detection, timely treatment, and strict medication adherence. TB is preventable and curable when patients complete their full course of treatment, reducing the risk of relapse and drug resistance. Routine screening, especially among high-risk groups and close contacts of TB patients, remains a key strategy.
The Ministry of Health continues to promote community awareness, cough etiquette, and regular health check-ups to limit transmission, particularly in densely populated and vulnerable communities.
While tuberculosis continues to challenge Bhutan’s health system, another infectious disease of concern, HIV/AIDS, has also shown an upward trend in new cases and deaths.
As of December 2024, Bhutan has recorded a cumulative total of 1,020 HIV cases since 1993, resulting in 209 deaths overall.
The year 2024 recorded 21 deaths and 85 new cases.
Currently, 774 people are living with HIV, with 98 percent receiving antiretroviral therapy (ART).
This represents an increase from 2023, when 61 new cases were recorded, and the cumulative total was 935, with six deaths reported, highlighting a continuing rise in HIV infections in the country.
Antiretroviral Therapy (ART) is a treatment that uses a combination of medicines to control the virus, strengthen the immune system, prevent progression to AIDS, and reduce the risk of transmission.
Preventing HIV transmission remains a public health priority, with officials stressing the importance of safe sexual practices, regular testing, and early initiation of treatment.
The bulletin highlights that individuals on antiretroviral therapy with suppressed viral loads are significantly less likely to transmit the virus. Awareness programs, stigma reduction, and confidential testing services are critical to encouraging people to seek timely care. Health authorities also continue to promote prevention of mother-to-child transmission and targeted outreach to populations at higher risk.
Furthermore, the bulletin reports a fourfold increase in Malaria cases.
In 2024, Bhutan reported 144 malaria cases, marking a more than fourfold increase compared to 2023, when 18 cases were recorded.
According to the bulletin, “This surge is primarily attributed to a significant malaria outbreak in the bordering districts of Kokrajhar and Chirang in Assam, India.” “The outbreak has impacted communities living near the international border, with cases confined to these areas due to Bhutan’s robust real-time surveillance system and timely interventions,” states the report.
The most affected age group was 15 to 49 years, accounting for 65 percent of cases, a group that represents the country’s most mobile and economically active population.
In contrast, children under five years of age were the least affected, comprising only a small proportion of reported cases.
According to the report, “This pattern indicates that there is no established local transmission of malaria within Bhutan, reflecting the success of the country’s surveillance and control measures.”
The bulletin also highlights differences in gender distribution, with males accounting for 73 percent of cases, compared to 27 percent among females. According to the report, this disparity is attributed to higher exposure among men working in high-risk occupations such as border security, forestry, and farming, which often require prolonged presence in malaria-prone border areas
To further reduce the malaria burden and progress toward elimination, the bulletin emphasizes the importance of strengthening cross-border collaboration with neighboring countries to address outbreaks at their source.
It also stresses the need to enhance targeted prevention and protection measures for high-risk occupational groups, maintain strong surveillance systems for early detection and response, and increase public awareness and education in border communities.
