TB Elimination in India – Progress, Strategies and Challenges
iasparliament
March 25, 2026
Mains: GS II – Health
Why in News?
Recently, World Tuberculosis Day was Observed annually on March 24 as, the day commemorates Robert Koch’s discovery of the tuberculosis-causing bacterium in 1882.
What are the trends in TB reduction in India?
Decline in TB incidence (new cases) – India’s TB incidence has fallen by ~21% between 2015 and 2024.
This decline is almost double the global average (~12%).
Incidence rate improved to about 187 cases per 100,000 population (2024).
Decline in TB mortality (deaths) – Mortality dropped from 28 → 21 deaths per 100,000 (2015–2024).
This reflects better treatment access and earlier diagnosis.
Big improvement in detection & treatment coverage – Treatment coverage increased from ~53% (2015) → >92% (2024).
“Missing cases” reduced dramatically (from ~15 lakh to <1 lakh).
Massive screening campaigns (hundreds of millions screened).
Mixed trend in drug-resistant TB – Overall multidrug-resistant TB (MDR-TB) is gradually declining.
For Example, 28% decline in MDR-TB cases in Mumbai (2022–2025), but regional increases still occur (e.g., Uttar Pradesh).
Post-COVID disruption and recovery – TB control was disrupted during COVID-19 (2020–2022)
This caused:
Missed diagnoses
Temporary rise in transmission
Since 2023–2024, detection and incidence trends are improving again
High burden – India still has the highest TB burden globally
India accounts for ~25% of global TB cases
What is the nature and transmission tuberculosis?
Causative agent – Tuberculosis is caused by the bacterium Mycobacterium tuberculosis, primarily affecting the lungs but also capable of impacting other organs such as the brain, kidneys, and spine.
2 forms – The disease exists in two forms: latent and active TB.
While latent TB remains non-infectious, it can progress to active TB, especially among individuals with weakened immunity.
Transmission – the transmission of the diseases occurs through airborne droplets when an infected person coughs, sneezes, or speaks.
However, TB does not spread through casual contact such as handshakes, sharing food, or using public facilities.
Medical interventions – Early diagnosis and sustained treatment are critical, as untreated TB can be fatal.
Importantly, patients generally become non-infectious after two weeks of appropriate treatment, underscoring the importance of timely medical intervention.
What is the National Plan of India to End TB?
National Strategic Plan (NSP) 2020–25 – India’s commitment to eliminating TB is reflected in its National Strategic Plan (NSP) 2020–25, which is aligned with the Sustainable Development Goals.
4 pillars – The plan is structured around four pillars: Detect, Treat, Prevent, and Build.
Detect focuses on early and accurate diagnosis using advanced tools.
Treat emphasizes prompt, quality-assured treatment, including for drug-resistant TB.
Prevent involves contact tracing and preventive therapy among high-risk groups.
Build aims at strengthening health systems and addressing social determinants.
This integrated approach ensures that TB control is not merely a medical intervention but a comprehensive public health mission.
National TB Elimination Programme – The National TB Elimination Programme (NTEP), formerly known as RNTCP, serves as the backbone of India’s TB control efforts.
It incorporates modern diagnostics, free treatment services, and patient-centric support systems.
Key features of NTEP include:
Early diagnosis through high-quality molecular testing and community outreach
Free and standardized treatment for all TB patients
Integration with the private healthcare sector
Nutritional and financial support via direct benefit transfers
Contact tracing and preventive treatment for vulnerable populations
Multi-sectoral coordination to address socio-economic determinants
The programme represents a paradigm shift from disease control to disease elimination.
TB Mukt Bharat Abhiyaan – The Pradhan Mantri TB Mukt Bharat Abhiyaan, launched in 2022, has transformed TB elimination into a mass movement or Jan Andolan.
It seeks to mobilize individuals, communities, corporates, and civil society to support TB patients and strengthen public health efforts.
Under this initiative:
Over 20 crore individuals have been screened for TB
More than 28 lakh cases have been detected, including asymptomatic individuals
46,118 Gram Panchayats have achieved TB-free certification
Treatment success rates have reached 90%, exceeding the global average
The campaign demonstrates the power of community engagement in addressing public health challenges.
Nutrition and Care – Recognizing that TB is closely linked to malnutrition and poverty, the government has implemented targeted welfare schemes.
The Nikshay Poshan Yojana provides ₹1,000 per month to TB patients to ensure adequate nutrition during treatment.
Since its inception, thousands of crores have been disbursed to beneficiaries.
Complementing this is the Ni-kshay Mitra initiative, where volunteers provide food baskets, psychosocial support, and vocational assistance.
This approach addresses not only the medical but also the socio-economic dimensions of TB, improving treatment adherence and outcomes.
100-Day TB Mukt Bharat Abhiyaan – To accelerate progress, the government launched a 100-day intensive campaign in high-burden districts in December 2024.
This initiative focused on vulnerability mapping and active case finding.
The results have been significant:
Screening of over 20 crore people
Detection of 9 lakh asymptomatic cases
Enhanced awareness and community participation
By identifying hidden cases, the campaign has helped break the chain of transmission, a critical step toward elimination.
Medical Innovation – A major breakthrough in TB treatment is the introduction of the BPaLM regimen, comprising Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin.
This regimen is particularly effective for drug-resistant TB and has the following advantages:
Reduction of treatment duration to 6 months
Improved safety and efficacy
Better patient compliance
The adoption of such advanced treatment protocols reflects India’s commitment to incorporating global best practices.
Strengthening Healthcare Infrastructure – India’s TB elimination efforts are supported by a vast healthcare network, including Ayushman Bharat’s Ayushman Arogya Mandirs.
With over 1.84 lakh centres, these facilities provide accessible and affordable diagnostic and treatment services.
Additionally, the country has established:
Over 9,800 rapid molecular testing centres
107 advanced laboratories for drug susceptibility testing
This infrastructure ensures early detection and timely intervention, even in remote areas.
Leveraging Technology – India is at the forefront of integrating artificial intelligence into public health.
AI-based tools are being used for screening, diagnosis, and treatment monitoring.
Key innovations include:
Acoustic AI for cough analysis to detect TB signatures
Radiology AI for automated interpretation of chest X-rays
Predictive analytics to identify high-risk patients and prevent treatment failure
These technologies have improved detection rates and reduced adverse outcomes, demonstrating the transformative potential of digital health solutions.
Inclusive Healthcare Delivery – Efforts to eliminate TB extend to geographically isolated and underserved regions.
For instance, intensive screening campaigns in remote areas such as the Gurez Valley in Jammu and Kashmir have utilized mobile diagnostic units and portable X-ray machines.
Such initiatives highlight the government’s commitment to ensuring equitable healthcare access, regardless of geographical barriers.
What are the Challenges?
Persistent challenges – Despite significant progress, several challenges remain:
A large reservoir of latent TB infections
Rising cases of drug-resistant TB
Socio-economic factors such as poverty, malnutrition, and overcrowding
Gaps in awareness and stigma associated with the disease
Addressing these challenges requires sustained political commitment, increased investment in healthcare, and continued community participation.
What lies ahead?
India’s journey towards TB elimination represents one of the most ambitious public health missions in the world.
Through a combination of strategic planning, technological innovation, community engagement, and social support, the country has achieved substantial progress in reducing TB incidence and mortality.
However, the goal of eliminating TB by 2025 demands sustained efforts and vigilance. Strengthening healthcare systems, addressing social determinants, and leveraging emerging technologies will be crucial in maintaining momentum.
If current trends continue, India has the potential not only to meet its target but also to serve as a global model in the fight against tuberculosis.
