Don’t panic, TB is treatable and containable

TUBERCULOSIS (TB) is back in the headlines following an outbreak in Johor where 33 people were detected with the disease.

This alone has made people uneasy. But TB is not new, and this detected cluster in Kota Tinggi is not a sign that the system has failed.

In fact, it is the opposite. The cluster was detected, traced and managed quickly.

The cases in Johor got so much attention – they went viral on social media – because most of us assume the country is TB-free.

Malaysia implemented one of the most comprehensive public health interventions in the region as early as the 1960s to fight TB.

In the national prevention and treatment programme, Malaysians received free diagnosis, compulsory notification, access to rural clinics, and the introduction of BCG vaccination for infants. It was so successful that by the 1990s, cases and deaths fell sharply and became rare.

The disease had faded from public consciousness, and many assumed it had been eradicated. But TB never disappeared. It simply became quieter over the past 15 to 20 years, although in some years, case numbers crept back up. Covid-19 also disrupted screening and treatment, allowing undiagnosed cases to linger.

What we are seeing is not a failure but long-standing weaknesses becoming visible as case numbers rise.

The influx of foreign workers in Malaysia is also one of the main contributors to this rising number of TB cases. Many of them live in crowded conditions where TB spreads easily.

Screening exists, but the system often fails at the margins. Undocumented workers avoid clinics for fear of detention or deportation. Those who test positive for latent TB – not infectious and treatable – fear they may lose work permits, pushing them underground and away from treatment.

The Johor outbreak raises a broader point: while the Health Ministry is equipped to manage TB, it cannot do so alone. Border agencies, employers, housing authorities, and local governments also have roles to play.

Health screening at borders and entry points must strictly be carried out as a routine safeguard, not an emergency reaction. It is much cheaper, safer, and far less disruptive than trying to control an outbreak.

Malaysia already has a National Strategic Plan to end TB by 2030, which aligns with the global goal of a TB-free planet by 2035. We cannot lose sight of this.

The challenge in eliminating TB lies in late diagnosis and patients failing to complete long treatment courses. There is also a risk of drug resistance and gaps among migrant and mobile populations. Uneven screening and follow-up, public complacency, and weak coordination beyond the health sector are also issues that need to be tackled.

But with early detection, keeping patients on treatment, and separating healthcare from immigration enforcement, these measures can, to a certain degree, help reduce the number of infections.

Stronger follow-up, better coordination between agencies, targeted screening at borders and workplaces, and sustained public awareness would also play a critical role in enabling Malaysia to meet its 2030 target.

TB elimination depends less on new medicine and more on trust, continuity, and disciplined execution of tried and tested measures.

What we don’t need is social media panic and misinformation circulated by unthinking and ignorant netizens.