India Faces Significant TB Challenge Despite Progress in Treatment

The World Health Organization (WHO) released its Global Tuberculosis Report 2025 this week, revealing that tuberculosis (TB) remains one of the deadliest infections worldwide. In 2024, TB claimed over 1.2 million lives and affected approximately 10.7 million individuals globally. The report highlights India’s significant burden, noting that the country accounted for 25% of all TB cases.

According to the report, 87% of the world’s TB patients were concentrated in just 30 countries. India, Indonesia, and the Philippines had the highest incidence rates. Notably, despite ongoing challenges in funding and equitable access to healthcare, India has made measurable progress in diagnostics, treatment, and innovation in TB care.

India’s Progress in TB Management

India has witnessed a marked decline in TB incidence, dropping from 237 per 100,000 population in 2015 to 187 per 100,000 in 2024. This represents a 21% reduction, nearly double the global average decline. The Union Health Ministry reported that treatment coverage in India has reached 92%, surpassing many other high-burden countries.

As of 2025, Uttar Pradesh has the highest number of TB cases, followed by Maharashtra, Bihar, and Madhya Pradesh. While these states show high case numbers, Delhi has the highest prevalence rate of TB infections.

Challenges Impacting TB Elimination

In an ambitious move, the government renamed the Revised National Tuberculosis Control Programme (RNTCP) to the National TB Elimination Programme (NTEP) in 2020, aiming to eliminate TB by 2025, five years ahead of the global target of 2030. However, the country is grappling with several challenges that threaten this goal.

The burden of drug-resistant TB is significant, and healthcare infrastructure, particularly in rural areas, struggles to meet demands. Socio-economic disparities further complicate access to diagnosis and treatment. A healthcare worker involved in the TB elimination programme pointed out critical issues, including supply chain disruptions leading to drug stockouts, despite official denials of nationwide shortages.

An article published last year highlighted the stockouts of anti-TB drugs in many states, which forced patients to skip doses, jeopardizing treatment efficacy and progress made in recent years.

The stigma attached to TB also remains a barrier, complicating efforts to encourage patients to seek timely treatment.

Innovative Approaches to Reduce TB Incidence

To combat these challenges, the Central Government has implemented aggressive measures focused on extensive screening and treatment. The establishment of the world’s largest TB laboratory network, with 9,391 rapid molecular testing facilities and 107 culture and drug susceptibility testing laboratories, is a significant step forward.

Additionally, the government has enhanced community screening efforts with over 500 AI-enabled handheld chest X-ray units and plans to distribute 1,500 more across states and union territories. The program has decentralized services through 178,000 Ayushman Arogya Mandirs, facilitating closer access to TB care.

Nutritional support for TB patients has also increased through the Direct Benefit Transfer (DBT) under the Ni-kshay Poshan Yojana (NPY), raising the monthly assistance from ₹500 to ₹1,000 for the duration of treatment. Furthermore, ASHA workers have received training to identify early warning signs in their communities and refer patients to appropriate treatment facilities.

The WHO’s report indicated that between 2023 and 2024, the global incidence of TB declined by nearly 2%, with deaths from the disease falling by 3%. Since the year 2000, timely treatment has reportedly saved an estimated 83 million lives worldwide.

Despite these advancements, global funding for TB remains stagnant, with only $5.9 billion available for prevention, diagnosis, and treatment in 2024. This figure represents just over a quarter of the $22 billion annual target set for 2027. Funding for TB research also lags, reaching only $1.2 billion in 2023, which is 24% of the targeted amount.

The report highlights ongoing development in TB treatment, with 63 diagnostic tests and 29 drugs currently in clinical trials, marking a significant increase from just eight in 2015. Additionally, 18 vaccine candidates are undergoing clinical trials, offering hope for future advancements in TB prevention and treatment.

India’s efforts to tackle TB demonstrate a complex landscape of progress and ongoing challenges, emphasizing the need for continued innovation and investment in healthcare to achieve the goal of elimination.