India’s Progress in Tuberculosis Elimination Efforts

World Tuberculosis (TB) Day is observed annually on March 24. It aims to raise awareness about TB and its global impact. As of 2025, India strives to meet the United Nations Sustainable Development Goals (SDGs) to end the TB epidemic by 2030. However, challenges remain . The 2015 End TB targets focus on reducing TB incidence by 90 per cent and TB mortality by 95 per cent.

Current Status of TB in India

India accounts for 26 per cent of global TB cases. The incidence rate stands at 195 cases per 100,000 population. In 2023, India reported 2.552 million TB cases, falling short of the target of 2.762 million. Undiagnosed cases remain a major concern, contributing to the spread of TB. The complexity of TB diagnostics and treatment complicates efforts to control the disease.

TB Treatment Coverage and Success Rates

The TB Treatment Coverage in India reached 92.4 per cent, exceeding the global target of 90 per cent. The Treatment Success Rate was 87.6 per cent in 2022, slightly below the 92 per cent target. However, only 21 per cent of suspected TB cases were tested using advanced molecular diagnostics, while 79 per cent relied on microscopy, which has limitations.

Challenges in TB Diagnostics

Microscopy is less sensitive for detecting TB in certain populations, such as HIV-positive individuals and children. It also cannot identify drug-resistant strains. The reliance on skilled technicians increases the risk of false negatives. In 2023, only 58 per cent of TB patients received drug susceptibility testing (DST), and the success rate for drug-resistant cases was only 65 per cent.

National TB Elimination Programme (NTEP) Initiatives

The NTEP aims to identify missing TB cases and improve treatment outcomes. The programme promotes active case finding and preventive treatment. It recommends screening 110,000 people per million in vulnerable populations. The goal is to ensure 98 per cent of patients receive DST and achieve a treatment success rate of 92 per cent for drug-sensitive patients.

Community Engagement and Innovative Approaches

Community involvement is crucial for TB control. Initiatives like “Ni-kshay Mitra” aim to enhance participation from civil society. This engagement can improve treatment adherence and support patients in navigating the healthcare system. Mobile diagnostic units are also being deployed to reach remote areas, enhancing accessibility to diagnostics and treatment.

Future Directions for TB Control

To meet the SDG target of reducing TB incidence to 47 cases per 100,000 population by 2030, India must achieve an annual decline of 21 points. Strengthening healthcare infrastructure is essential. This includes training healthcare workers, expanding access to molecular diagnostics, and ensuring free treatment for all patients. Collaboration with the private sector can improve diagnostic standards and case notifications.

The 100-Day Campaign

Launched on December 7, 2024, the 100-day campaign aims to detect an additional 200,000 TB cases. It seeks to achieve 90 per cent screening through X-rays and testing via NAAT. The campaign will also ensure full coverage under the Ni-kshay Poshan Yojana and engage the community through Ni-Kshay Mitra.

Questions for UPSC:

1. Discuss the impact of social determinants on the spread of Tuberculosis in India.
2. Critically examine the role of molecular diagnostics in the management of Tuberculosis.
3. What is the significance of community engagement in public health initiatives? Explain with examples.
4. What are the challenges faced by India in achieving the Sustainable Development Goals related to health? Discuss.

Answer Hints:

1. Discuss the impact of social determinants on the spread of Tuberculosis in India.

1. Poverty and inadequate living conditions contribute to higher TB incidence, as malnutrition weakens immunity.
2. Lack of access to healthcare services hinders timely diagnosis and treatment, exacerbating the spread.
3. Social stigma around TB may discourage individuals from seeking care, leading to undiagnosed cases.
4. Urban slums and rural areas often lack proper sanitation and overcrowded living conditions, facilitating transmission.
5. Educational disparities affect awareness and understanding of TB, influencing health-seeking behavior.

2. Critically examine the role of molecular diagnostics in the management of Tuberculosis.

1. Molecular diagnostics like NAAT offer rapid and accurate detection of TB, improving case identification.
2. They can detect drug-resistant strains, which is crucial for effective treatment planning.
3. Despite their advantages, only 21% of suspected cases were tested using molecular methods, indicating underutilization.
4. Complexity and cost of molecular tests can limit their availability in resource-poor settings.
5. Training healthcare personnel is essential to ensure accurate interpretation and implementation of results.

3. What is the significance of community engagement in public health initiatives? Explain with examples.

1. Community engagement encourages trust and collaboration between health authorities and the population, enhancing program effectiveness.
2. Initiatives like “Ni-kshay Mitra” mobilize local support, improving treatment adherence and care-seeking behavior.
3. Community involvement in screening and awareness campaigns can lead to early detection and treatment of TB cases.
4. Engaging local leaders can help address stigma and misinformation surrounding TB, promoting a supportive environment.
5. Successful community engagement can be seen in vaccination drives, where local participation increases coverage rates.

4. What are the challenges faced by India in achieving the Sustainable Development Goals related to health? Discuss.

1. High incidence of TB and other communicable diseases complicates the path to achieving SDG health targets.
2. Healthcare infrastructure is often inadequate, particularly in rural and underserved areas, limiting access to services.
3. Drug resistance and undiagnosed cases remain barriers to effective disease management.
4. Social determinants such as poverty, education, and stigma affect health outcomes and access to care.
5. Coordination between public and private sectors is necessary but often lacking, hindering comprehensive health strategies.