India remains a major contributor to global tuberculosis (TB) cases in 2025. Despite steady progress, the country is far from achieving its ambitious goal of eliminating TB by 2025. The Global TB Report 2025 reveals critical data on case numbers, treatment coverage, drug resistance, and innovations in TB control.
Current TB Situation in India
In 2024, India reported approximately 27.1 lakh TB cases and over three lakh deaths. This makes India one of the highest TB burden countries globally. TB remains the deadliest infectious disease worldwide, infecting 10.7 million people and causing 1.23 million deaths in 2024. India diagnosed a record 26.18 lakh cases in 2024, narrowing the gap between estimated and diagnosed cases. However, India still accounts for 8.8% of the global gap in undiagnosed TB, second only to Indonesia.
India’s Elimination Targets and Progress
India aims to eliminate TB by 2025, five years ahead of the global target. Elimination means less than one TB case per million population. The World Health Organization’s End TB strategy sets interim goals of 80% reduction in new cases and 90% reduction in deaths by 2030. India has achieved only a 21% reduction in new cases and 28% reduction in deaths from 2015 to 2024. This falls short of the 2025 milestones of 50% and 75% reductions respectively. India’s progress, however, exceeds the global average decline of 12% in incidence.
Diagnosis and Treatment Coverage
India’s treatment coverage rose to 92% in 2024 from 85% in 2023 and 53% in 2015. This improvement is due to innovative case-finding, decentralising services, and community mobilisation. The introduction of the BPaL regimen has shortened treatment for drug-resistant TB from 18-24 months to six months. Despite progress, challenges remain in childhood TB diagnosis and preventive treatment availability. Drug supply inconsistencies have also been reported in some regions.
Drug-Resistant Tuberculosis Challenges
India contributes nearly one-third of global drug-resistant TB cases. In 2024, 12.63% of previously treated and 3.64% of new TB cases were drug-resistant. The number of drug-resistant cases rose slightly to 1.27 lakh from 1.24 lakh in 2023. Treatment success rate in India stands at 90%, above the global average of 88%. Factors hindering TB control include treatment interruption, Covid-19 disruptions, air pollution, and rising diabetes cases, which increase TB risk.
Innovations and Screening Initiatives
India has adopted AI-enabled portable X-ray devices to detect asymptomatic TB during community screening. The government’s 100-day campaign screened over 19 crore vulnerable individuals, detecting 24.5 lakh TB cases, including 8.61 lakh asymptomatic ones. These measures reflect a proactive approach to tackling TB in high-burden settings and improving early diagnosis and treatment.
Questions for UPSC:
- Discuss the challenges and strategies in achieving tuberculosis elimination targets in India in the light of the Global TB Report 2025.
- Explain the impact of drug-resistant tuberculosis on public health and analyse the role of treatment adherence in controlling its spread.
- Critically examine the effects of environmental factors such as air pollution and lifestyle diseases like diabetes on the prevalence of tuberculosis in urban India.
- With suitable examples, discuss the role of technology and community mobilisation in enhancing disease surveillance and control in infectious diseases.
Answer Hints:
1. Discuss the challenges and strategies in achieving tuberculosis elimination targets in India in the light of the Global TB Report 2025.
- India recorded 27.1 lakh TB cases and 3+ lakh deaths in 2024, indicating a high disease burden.
- Elimination target (less than 1 case/million) by 2025 is far from reach; only 21% reduction in new cases and 28% in deaths achieved since 2015.
- Challenges include gaps in diagnosis (8.8% global gap), incomplete treatment, and resource diversion during Covid-19.
- Strategies include innovative case finding, decentralisation of services, community mobilisation, and shorter treatment regimens like BPaL.
- Improved treatment coverage to 92% in 2024 from 53% in 2015 shows progress but childhood TB and preventive treatment remain weak spots.
- Need for stakeholder consultation and gap analysis involving patients, healthcare workers, labs, and regulators to strengthen the programme.
2. Explain the impact of drug-resistant tuberculosis on public health and analyse the role of treatment adherence in controlling its spread.
- India accounts for nearly one-third of global drug-resistant TB cases, with 1.27 lakh cases in 2024.
- Drug-resistant TB poses higher treatment complexity, longer duration, and increased mortality risk.
- Treatment interruption or non-adherence leads to development and transmission of resistant strains.
- Introduction of all-oral shorter regimens (BPaL) improves adherence and outcomes for resistant TB.
- Treatment success rate in India is 90%, above global average, but gaps remain in drug availability and patient follow-up.
- Covid-19 pandemic diverted resources, worsening treatment continuity and contributing to resistance spread.
3. Critically examine the effects of environmental factors such as air pollution and lifestyle diseases like diabetes on the prevalence of tuberculosis in urban India.
- Air pollution exacerbates respiratory health, worsening TB outcomes especially in cities like Delhi.
- Rising diabetes prevalence increases susceptibility to TB; estimated 3.2 lakh TB cases in 2024 attributable to diabetes.
- Both factors impair immune response, facilitating TB infection and progression from latent to active disease.
- Urban lifestyle changes and overcrowding increase transmission risk and complicate TB control.
- Addressing environmental and lifestyle factors is essential alongside medical interventions for TB reduction.
- Integrated public health policies targeting pollution control and diabetes management can reduce TB burden.
4. With suitable examples, discuss the role of technology and community mobilisation in enhancing disease surveillance and control in infectious diseases.
- AI-enabled handheld X-ray devices detect asymptomatic TB cases, improving early diagnosis during community screening.
- India’s 100-day campaign screened over 19 crore vulnerable individuals, detecting 24.5 lakh TB cases, including 8.61 lakh asymptomatic ones.
- Decentralisation and large-scale community mobilisation increased treatment coverage from 53% in 2015 to 92% in 2024.
- Use of digital tools and data analytics enhances real-time surveillance and targeted interventions.
- Community engagement raises awareness, reduces stigma, and encourages treatment adherence.
- Such innovations and participatory approaches are replicable models for control of other infectious diseases.
