Opinion India’s TB successes — and the long road ahead

In 2018, the government announced its intention to eliminate tuberculosis in the country by 2025, five years ahead of the global target. For more than three years, reports and surveys have consistently highlighted that the country is not on track to reach this milestone, despite making appreciable progress. The WHO’s annual Global TB report, released last week, confirms the high burden of TB cases in the country as 2025 draws to a close. In 2024, India recorded more than 27 lakh TB cases. India has achieved a 21 per cent reduction in the incidence of this bacterial disease since 2015 and a 28 per cent decline in TB deaths in the past nine years. However, the WHO report also shows that the country with the highest burden of the deadliest infection in the world has also been at the forefront in combating it – globally, TB incidence went down by 12 per cent between 2014 and 2025.

Among the reasons for India’s improved performance is the ability of its healthcare system — enabled by improved testing facilities — to diagnose more than 80 per cent of the estimated cases, a far cry from 2015 when close to 50 per cent of those infected by TB fell outside the radar. This means that although on the face of it, the 27 lakh cases reported in 2024 represent only a minor improvement from the 28 lakh TB patients detected in 2022, the latest figure is a more accurate representation of the incidence of the disease in India. At the same time, the system’s increasing proficiency at detecting cases indicates that hospitals, healthcare centres and individual doctors have to care for more patients, many of whom are afflicted by the more virulent multidrug resistant strain of the disease. Initiatives such as the BPaLM regimen which can cut treatment time for the multidrug TB by six months, have helped in the expansion of treatment. Even then, patients stopping therapy midcourse remains a major concern.

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The next steps in eliminating TB should involve taking cues from new research. For example, there is evidence that pollution worsens the outcome for TB patients, and the disruption of their immune system makes diabetics more vulnerable to the bacterial disease. The WHO report should lead to building on the successes, identifying gaps, and plugging them.