India’s Progress Against Tuberculosis and the Challenges Ahead – Chinmaya IAS Academy

India has set an ambitious target to eliminate Tuberculosis (TB) by 2025, five years ahead of the global deadline.
Recent data from 2024 shows improved detection and reporting, reflecting strengthened public health systems.
However, experts and reports caution that structural, medical, and social challenges may hinder achievement of the elimination goal within the set timeline.

Over 27 lakh TB cases were recorded in 2024.
Since 2015:
- 21% reduction in TB incidence
- 28% decline in TB-related deaths over the past nine years
India’s health system can now diagnose over 80% of estimated TB cases, a substantial improvement from 2015.

The rise in reported TB cases reflects:
- Improved surveillance and detection
- Expanded diagnostic infrastructure
It does not necessarily indicate an actual surge in TB infections.

Despite notable gains, assessments suggest India is not fully on track to meet the 2025 TB elimination target.
Medical advancements:
- Introduction of the bPaLM regimen has:
  - Shortened treatment duration
  - Improved outcomes for multi-drug resistant TB (MDR-TB)
Persistent challenges include:
- Patient adherence to long-duration TB treatment
- Risk of drug resistance due to incomplete therapy
Co-morbid and social determinants:
- Diabetes, undernutrition, and air pollution worsen TB outcomes
- These factors require multi-sectoral interventions, beyond healthcare alone
Governance and implementation issues:
- Need for stronger last-mile delivery
- Continuous monitoring and follow-up of patients
- Addressing stigma associated with TB to ensure early reporting and treatment completion
Experts emphasize that elimination requires:
- Sustained political commitment
- Community participation
- Integration of TB control with broader public health and social welfare measures