India’s Fight Against Tuberculosis Gains Momentum
Context
World Tuberculosis Day is observed annually on March 24 to commemorate Robert Koch’s discovery of the tuberculosis-causing bacterium in 1882.
India’s Progress in Controlling Tuberculosis
Sharp fall in new infections – India has recorded a decline of nearly 21% in TB incidence between 2015 and 2024, significantly outperforming the global reduction of around 12%. The incidence rate now stands at approximately 187 per lakh population.
Reduction in fatalities – TB-related deaths have decreased from 28 to 21 per lakh population during the same period, indicating improvements in healthcare delivery and early detection.
Expansion of diagnosis and treatment – Treatment coverage has expanded from about 53% in 2015 to over 92% in 2024. The number of “missing cases” has drastically reduced from around 15 lakh to below 1 lakh due to large-scale screening drives.
Drug-resistant TB trends – While multidrug-resistant TB is showing an overall decline (e.g., 28% reduction in Mumbai), certain regions continue to report rising cases, highlighting uneven progress.
Impact of pandemic disruption – TB services were affected during the COVID-19 period (2020–22), leading to missed diagnoses and higher transmission. However, recovery trends since 2023 indicate renewed progress.
Continuing burden – India still contributes nearly one-fourth of the global TB cases, maintaining its position as the highest-burden country.
Understanding Tuberculosis: Nature and Spread
Causative organism – TB is caused by Mycobacterium tuberculosis, mainly affecting the lungs but also impacting organs such as the brain, kidneys, and spine.
Forms of disease – TB exists as latent (non-infectious) and active (infectious) forms, with latent cases posing a risk of activation under weakened immunity.
Mode of transmission – It spreads through airborne droplets released during coughing, sneezing, or speaking, and not via casual contact like sharing food or handshakes.
Treatment dynamics – Early diagnosis and sustained therapy are essential. Patients typically become non-infectious after two weeks of proper treatment.
India’s Strategy for TB Elimination
National Strategic Plan (2020–25) – India’s TB elimination roadmap aligns with SDGs and is built on four pillars: Detect, Treat, Prevent, and Strengthen systems.
- Detect – Focus on early and accurate diagnosis using modern technologies
- Treat – Ensuring quality treatment, including for drug-resistant TB
- Prevent – Emphasis on contact tracing and preventive therapy
- Strengthen – Addressing systemic and socio-economic factors
Institutional Framework: NTEP
Programme evolution – The National TB Elimination Programme (earlier RNTCP) forms the core of India’s TB control strategy.
Key components:
- Advanced molecular diagnostics and active case finding
- Free and standardized treatment for all patients
- Integration with private healthcare providers
- Nutritional and financial assistance through DBT
- Focus on vulnerable populations and social determinants
Jan Andolan Approach: TB Mukt Bharat Campaign
Mass participation model – Launched in 2022, this initiative transforms TB elimination into a people’s movement.
Major achievements:
- Screening of over 20 crore individuals
- Detection of more than 28 lakh cases, including asymptomatic ones
- Certification of over 46,000 TB-free Gram Panchayats
- Treatment success rate reaching ~90%
Social Support and Nutrition Initiatives
Nutritional assistance – Under Nikshay Poshan Yojana, TB patients receive ₹1,000 per month for dietary support.
Community engagement – Ni-kshay Mitra initiative encourages volunteers to provide nutritional, emotional, and vocational assistance, improving treatment adherence.
Targeted Campaigns for Acceleration
100-Day Intensified Drive (2024–25) – Focused on high-burden districts through vulnerability mapping and active screening.
Outcomes:
- Screening of over 20 crore individuals
- Identification of 9 lakh asymptomatic cases
- Improved awareness and early detection
Advances in Treatment and Technology
New drug regimen (BPaLM) – A shorter, more effective treatment for drug-resistant TB using Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin.
Benefits:
- Reduced treatment duration to 6 months
- Higher success rates and better compliance
Digital innovations:
- AI-based cough analysis
- Automated chest X-ray interpretation
- Predictive analytics for risk assessment
Healthcare Infrastructure Strengthening
Expanded access – Ayushman Arogya Mandirs (1.8 lakh+ centres) ensure last-mile healthcare delivery.
Diagnostic network:
- 9,800+ rapid molecular testing centres
- 100+ advanced drug-susceptibility labs
Inclusive Outreach Efforts
Special initiatives in remote and underserved areas (e.g., Himalayan regions) using mobile diagnostic units ensure equitable healthcare access.
Key Challenges Remaining
Latent TB burden – A large pool of undetected latent infections persists.
Drug resistance – Rising complexity of MDR-TB cases.
Socio-economic barriers – Poverty, malnutrition, and overcrowding continue to drive transmission.
Awareness and stigma – Social stigma still hampers timely diagnosis and treatment.
Way Forward
India’s TB elimination mission represents a comprehensive public health effort combining policy, innovation, and community participation. Sustained investment, technological integration, and focus on social determinants will be essential to achieve the ambitious target of eliminating TB.
If current progress continues, India can emerge as a global leader in TB control and elimination.
Source : PIB