July 24, 2025
THIMPHU – The Annual Health Bulletin 2025 of the Ministry of Health (MoH) reveals clear patterns in the country’s ongoing battle against infectious diseases, with tuberculosis (TB), HIV/AIDS, and malaria continuing to pose significant public health challenges.
Despite robust surveillance and health infrastructure, the data indicate a mixed trend, with some diseases showing concerning increase in reported cases, demanding sustained and strategic interventions.
Tuberculosis remains a persistent threat, with the number of reported cases increasing steadily over the last three years.
In 2023, Bhutan registered 864 TB cases. This rose to 920 cases in 2024, reflecting a continuing burden despite the country’s comprehensive TB control strategy.
The National Tuberculosis Control Programme (NTCP) has been instrumental in leading these efforts, ensuring diagnostic and treatment services are accessible even in remote regions.
Yet, multidrug-resistant TB (MDR-TB), treatment non-compliance, and disease relapse remain significant challenges. In 2024 alone, there were 38 pulmonary TB relapses and 17 extrapulmonary TB relapses.
The majority of TB cases in 2024 (65 percent) were pulmonary, with 552 confirmed through bacteriological testing. A substantial proportion occurred in the economically active age group, mirroring the 2023 data, which showed the highest incidence among the 15–24-year demographic, especially females.
In 2023, 98 females and 72 males were diagnosed with new pulmonary bacteriologically confirmed TB, with extrapulmonary TB cases also skewing heavily towards younger females.
These patterns underscore a need for age- and gender-specific interventions, improved awareness, and strengthened diagnostic coverage, particularly in youth populations.
The rise in total TB cases from 809 in 2022 to 920 in 2024 reflects the ongoing struggle to fully contain transmission and the importance of maintaining high-quality treatment adherence and education efforts.
HIV/AIDS trends also show a steady rise in new infections. In 2023, 61 new cases were reported, rising to 85 in 2024, bringing the cumulative number of HIV infections since 1993 to 1,020.
Deaths attributed to HIV have also increased from 6 in 2023 to 21 in 2024, highlighting the disease’s ongoing impact despite the country’s commitment to the 95–95–95 UNAIDS targets.
As of December 2024, 774 people are living with HIV in Bhutan, with 98 percent of them receiving antiretroviral therapy (ART).
The introduction of Pre-exposure Prophylaxis (PrEP) in 2024 for high-risk groups in Paro and Thimphu marked a progressive step in preventive care. However, the continuous rise in new infections underscores the need to expand such measures nationwide and further strengthen HIV awareness, testing, and treatment adherence.
While Bhutan has made significant strides toward malaria elimination, the 2024 data revealed an unexpected and sharp resurgence in cases, rising to 144 from just 18 in 2023 and 6 in 2022. This more than four-fold increase is attributed primarily to a large outbreak across the border in Assam, India.
Bhutan’s real-time surveillance and containment systems proved effective in localising the impact, with cases confined to border districts. Of the 144 cases, 71 were imported, and 73 introduced, resulting from transmission following cross-border exposure.
However, none were indigenous cases, confirming that internal transmission remains effectively controlled. Plasmodium vivax accounted for approximately 95 percent of all infections.
The demographic most affected by malaria in 2024 was the 15–49 age group (65 percent), which represents the most mobile and economically active section of the population. Males were disproportionately impacted (73 percent), largely due to their roles in border-related occupations such as forestry, farming, and security.
This occupational exposure highlights the importance of targeted malaria interventions for high-risk groups and the need for stronger cross-border coordination to prevent future outbreaks.
The absence of indigenous malaria cases supports Bhutan’s continued progress toward WHO malaria elimination certification, but the sudden spike in cases in 2024 demonstrates how vulnerable even well-controlled systems remain to regional epidemiological dynamics.
The latest data showing rising trends in TB, HIV/AIDS, and malaria underscores the need for more targeted and strategic interventions, despite the progress Bhutan has made in tackling these diseases.