OECD 2위 결핵 발생국 대한민국…집단시설 관리체계는 ‘빈틈’

The Korean Ministry of Health and Welfare has been criticized for having a lax management system for managing tuberculosis (TB) in collective facilities, such as hospitals, kindergartens, and schools. While TB testing is legally mandatory, there is no government system in place to verify whether such testing is actually being carried out.

As of now, Korea ranks second highest among OECD member countries in terms of TB incidence rates. Recently, TB outbreaks in collective facilities have been on the rise again, raising concerns. According to a report by the National Assembly Budget Policy Office, out of 93,462 facilities in South Korea, only 21,420 (22.7%) responded to the TB and latent TB infection testing implementation survey conducted by the Korea Disease Control and Prevention Agency (KDCA) in October 2023.

The purpose of TB prevention is to test all personnel in collective facilities and prevent the spread of TB. The problem lies in the fact that while testing is legally mandatory, the actual implementation is left solely to the voluntary reporting of collective facilities. The current law does not require facilities to report the status of testing to national or local governments.

The Budget Policy Office noted that "although TB outbreaks in collective facilities are on the increase, the response rate in the survey of TB testing institutions is low, and an effective testing implementation inspection system needs to be established." The KDCA also assessed in its 2023 third comprehensive TB management plan (2023-2027) that the lack of a practical implementation inspection system for TB testing in collective facilities has led to a decrease in the effectiveness of the measures.

While the number of Korean TB patients has been decreasing, TB outbreaks in collective facilities have been increasing again recently. The number of TB patients in collective facilities decreased from 7,161 in 2021 to 6,185 in 2024, but increased to 7,070 in 2025. Overall, the number of TB patients in Korea decreased from 22,904 in 2021 to 17,070 in 2023.

Korea's TB incidence rate, often referred to as the "backward country type disease," is currently ranked second among OECD member countries at 35 per 100,000 people, behind Colombia at 49. The TB mortality rate (per 100,000 people) is also the third highest among OECD member countries. A spokesperson for the KDCA said that an aging population is one of the reasons for the high incidence rate.

As the elderly population has a higher risk of contracting TB during their younger years, their latent TB infection rate is high. The spokesperson also explained that as people age, their immune system weakens, and latent TB bacteria can develop into active TB disease. The KDCA plans to release a long-term investigation plan by December this year, including the establishment of legal grounds for mandatory reporting and testing.