Why in the News?

• The WHO Global TB Report 2025 highlighted that India’s TB incidence has declined by 21% since 2015.

What’s in Today’s Article?

• Burden of TB (Background, Global & National Burden, Govt Initiatives, Policy Framework, Challenges, Way Forward, etc.)

Background

• The World Health Organisation Global Tuberculosis Report 2025 has reaffirmed that tuberculosis (TB) continues to be among the world’s deadliest infectious diseases, claiming over 1.2 million lives and affecting 10.7 million people globally in 2024.
• While India remains the largest contributor to the global TB burden, the country has made significant strides in reducing incidence, with a 21% decline between 2015 and 2024, nearly double the global average rate of decline.
• However, despite these achievements, India has missed its self-imposed target of eliminating TB by 2025, underscoring persistent challenges such as drug-resistant strains, healthcare gaps, and social stigma.

Global and National Burden of Tuberculosis

• According to the WHO report, 87% of the world’s TB cases are concentrated in just 30 countries, with India (25%) leading the list, followed by Indonesia (10%), the Philippines (6.8%), China (6.5%), and Pakistan (6.3%).
• India’s estimated TB incidence rate fell from 237 per lakh population in 2015 to 187 per lakh in 2024, marking a commendable improvement in detection and treatment coverage.
• The Union Health Ministry reported that India’s treatment coverage now stands at 92%, outpacing most high-burden countries.
• States such as Uttar Pradesh, Maharashtra, Bihar, and Madhya Pradesh account for the highest number of TB cases, while Delhi records the highest infection prevalence rate.

Government Initiatives and Policy Framework

• India’s TB elimination efforts are anchored in the National Tuberculosis Elimination Programme (NTEP), launched in 2020 after rebranding the earlier Revised National TB Control Programme (RNTCP).
• The NTEP set an ambitious goal to eliminate TB by 2025, five years ahead of the global target of 2030. Key interventions under the NTEP include:

• Expanded Diagnostic Infrastructure - India has established 9,391 rapid molecular testing laboratories and 107 culture and drug susceptibility testing labs, forming the largest TB diagnostic network in the world.
• Use of Technology and AI - Over 500 AI-enabled portable X-ray units have been deployed nationwide to enhance community screening, with 1,500 more units planned for delivery.
• Decentralised TB Care through Ayushman Arogya Mandirs - Around 1.78 lakh primary health centres provide TB services closer to communities, improving accessibility.
• Nutritional Support under Ni-kshay Poshan Yojana - Monthly Direct Benefit Transfer (DBT) to TB patients has been doubled from Rs. 500 to Rs. 1,000, supporting better treatment adherence and recovery.
• Community and ASHA Worker Engagement - Accredited Social Health Activists (ASHAs) have been trained to identify early TB symptoms and ensure treatment compliance.

Persistent Challenges in TB Elimination

• Drug-Resistant Tuberculosis (DR-TB)
  • India has one of the highest burdens of multi-drug-resistant TB (MDR-TB) in the world, making treatment longer, more expensive, and less effective.
  • Drug resistance continues to threaten the country’s progress in curbing overall TB cases.
• Healthcare Infrastructure and Workforce Gaps
  • Rural and remote areas continue to face shortages of trained personnel, diagnostic delays, and weak referral systems, affecting timely detection and treatment.
• Supply Chain and Drug Stockouts
  • Periodic disruptions in the anti-TB drug supply chain have led to stockouts in several states, forcing patients to skip doses, a critical risk factor for developing drug resistance.
  • Although authorities have denied widespread shortages, regional inconsistencies persist.
• Funding and Research Deficits
  • Globally, only $5.9 billion was available for TB control in 2024, just a quarter of the $22 billion annual target set for 2027.
  • Research funding remains limited at $1.2 billion (24% of the target). These shortfalls directly impact the rollout of new diagnostics, drugs, and vaccines.
• Social Stigma and Awareness Gaps
  • Deep-rooted stigma and discrimination discourage patients from seeking diagnosis and adhering to treatment, particularly among women and marginalised groups.

Global Efforts and India’s Role

• The WHO highlighted that globally, TB incidence fell by 2% between 2023 and 2024, and deaths decreased by 3%. Since 2000, timely diagnosis and treatment have saved 83 million lives.
• India’s accelerated decline in TB incidence, nearly twice the global average, demonstrates strong national ownership and effective public health strategies.
• The government’s expansion of the “Ni-kshay Mitra” initiative, under which individuals and organisations adopt TB patients to provide nutritional and social support, has also gained momentum.
• However, to meet the global End TB Strategy, India must sustain annual declines of 10-12%, supported by greater investment, innovation, and intersectoral collaboration.

Way Forward

• Experts emphasise the need for a multi-pronged strategy focusing on:

• Universal access to diagnosis and treatment, especially for marginalised communities.
• Integration of TB care with primary health services to ensure continuity.
• Scaling up digital surveillance and AI-based diagnostic tools.
• Increased domestic and global funding for TB research and vaccine development.
• Public awareness and destigmatisation campaigns to encourage early treatment.