New data show about 1,500 people have been infected with active tuberculosis in the Pacific region per year for the past three years.
The slowly developing bacterial infection usually affects the lungs and is generally curable.
However, the data released by the Secretariat of the Pacific Community indicate many cases in the region involve a drug-resistant strain.
The data show Micronesia has the highest TB rate with 140 people per 100,000 infected.
Melanesian countries have an average of 37 cases per 100,000, while Polynesian countries have 19.
The Secretariat of the Pacific Community's Dr Janet O'Connor says TB is a huge burden for the region and health officials are alarmed by a rise of a drug-resistant strain.
Ms O'Connor says a total of nine countries in the region had cases of Multi drug resistant strain (MDR-TB) with Papua New Guinea alone said to suffer from about 900 cases a year.
She's worried that the situation could escalate