Editorial: India’s war on TB far from over
Despite progress, India falls short of the goal of eliminating the bacterial disease by 2025 end
Despite making significant progress in reducing the number of tuberculosis cases, India still falls short of the goal of eliminating the bacterial disease by the end of 2025. Last year, the country recorded more than 27 lakh TB cases. Uttar Pradesh has the highest number of cases, followed by Maharashtra, Bihar and Madhya Pradesh. The latest annual Global TB report by the World Health Organisation (WHO) paints a grim picture, illustrating the high burden of TB cases as 2025 draws to a close. However, it must be said to the credit of healthcare authorities and dedicated workers that India has achieved a 21 per cent reduction in the incidence of the disease since 2015, from 237 per lakh population in 2015 to 187 per lakh population in 2024, and a 28 per cent decline in TB deaths in the past nine years. The progress, no doubt, has been credible, as reflected by the ability of the healthcare system to diagnose the cases at an early stage through improved testing facilities. Tuberculosis remains one of the world’s deadliest infections. Last year, nearly 87 per cent of the world’s TB patients were concentrated in 30 countries, with India accounting for the highest rate at 25 per cent, followed by Indonesia (10 per cent), the Philippines (6.8 per cent), and China (6.5 per cent). There is fresh evidence linking pollution to the worsening of the TB condition among patients, and the disruption of their immune system makes diabetics more vulnerable to the bacterial disease. Healthcare authorities must factor this environmental threat into the anti-TB strategies to make them more effective.
In 2020, the government renamed the Revised National Tuberculosis Control Programme (RNTCP) as the National TB Elimination Programme (NTEP) and set 2025 as the target for total elimination of the disease. However, the goal has been missed, and the disease continues to impact many, posing serious health, social, and economic challenges. A weak healthcare infrastructure, especially in rural areas, and socio-economic disparities affect access to diagnosis and treatment. Other key issues include supply chain disruptions, a shortage of trained personnel, and social stigma attached to the disease. The growing number of drug-resistant TB cases in the country is another area of concern. India recorded the highest number of multidrug-resistant TB cases in 2024 — accounting for 32 per cent of global MDR-TB — and rifampicin-resistant (RR-TB) cases. The fight against TB is blunted by challenges like inadequate diagnostic facilities and delayed detection. The sooner treatment commences, the quicker the cycle of airborne transmission is halted. With under-investment in public health and the TB programme, the public sector is overstretched. Because of the deficiencies in the public sector, nearly 80 per cent of Indian TB patients choose to incur large out-of-pocket expenses and seek treatment with unregulated private practitioners. This stark gap reveals the strain on India’s health infrastructure and the impact on patients whose access to quality care remains inconsistent.
