The Bhutanese Leading the way.
To combat tuberculosis (TB) and align with the global End TB Strategy, the Ministry of Health (MoH) has set ambitious targets to reduce TB incidence by 80% and mortality by 90% by 2030, using 2015 as the baseline year.
Recognizing that 83% of TB cases affect the economically productive age group of 15-44 years, MoH has strengthened its National Strategic Plan, ensuring early diagnosis, rigorous follow-up, and effective treatment for all patients.
Health Secretary, Pemba Wangchuk, highlighted Bhutan’s commitment to eliminating TB as a public health threat. “We are adopting cutting-edge diagnostic tools, expanding rapid testing facilities, and strengthening our follow-up mechanisms to ensure that no one is left behind in the fight against TB,” he said.
Bhutan’s TB control program includes the deployment of GeneXpert machines, which facilitate rapid molecular testing for multi-drug resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB).
MoH is scaling up the use of GeneXpert testing as the primary diagnostic tool while expanding rapid TB diagnostic services across the country. Currently, such services are available at 17 sites, but the government is working to increase accessibility.
This year, MoH will introduce the Cy-TB test, a next-generation skin test designed to detect latent TB infections (LTBI). This test will help identify individuals who have TB bacteria in their system but do not yet exhibit symptoms, enabling early intervention through TB Preventive Treatment (TPT) among close contacts of confirmed TB cases.
MoH is taking TB screening to the community level with the deployment of mobile TB screening vans. These will target high-risk groups, including people living with HIV (PLHIV), children under five years old, migrant workers in mining and industrial sites, prisoners, and those in congregate settings.
“The mobile TB units will allow us to reach populations that might otherwise be missed, ensuring faster diagnosis and immediate intervention,” the Health Secretary explained.
To enhance early detection, Bhutan has also integrated artificial intelligence (AI) into TB screening. By utilizing Qure AI technology, healthcare professionals can conduct faster and more efficient screenings, particularly in remote areas where radiologists may not be readily available.
Contact tracing is being intensified, especially among household and close contacts of TB and MDR-TB patients. MoH has introduced community-based healthcare initiatives to improve follow-ups, ensuring patients complete their treatment regimens.
“Patients will be followed up through an SMS alert system, phone calls, and home visits by health workers, particularly in cases of non-adherence,” the Health Secretary said, and further added, “This way, we ensure better compliance with treatment, reducing the risk of relapses and drug resistance.”
MoH has implemented WHO-recommended, all-oral shorter treatment regimens for both drug-susceptible TB and MDR-TB cases. Instead of the traditional 9 to 11-month regimens, patients with drug-susceptible TB can now complete treatment in four to six months, while MDR-TB patients receive treatment over six months.
“This shift to shorter regimens means fewer side effects, better adherence, and higher cure rates,” Pemba Wangchuk said.
Beyond diagnosis and treatment, Bhutan is tackling TB-related stigma, which often prevents individuals from seeking timely medical care. The government is conducting aggressive awareness campaigns to educate the public on TB symptoms, transmission, and the importance of early treatment.
“Reducing stigma is just as critical as medical intervention,” the Health Secretary said, and explained, “If people are afraid to come forward, we cannot eliminate TB. Public education is key to encouraging timely diagnosis and adherence to treatment.”
Combining cutting-edge diagnostics, mobile screening, AI technology, intensive patient follow-up, and shorter treatment regimens, the country is making significant strides toward achieving the End TB goals by 2030.
