A global model to overcome TB

Source: The post “A global model to overcome TB” has been created, based on “A global model to overcome TB” published in “The Hindu Businessline” on 06th December 2025.

UPSC Syllabus: GS Paper-2- Issues Relating to Development and Management of Social Sector/Services relating to Health, Education, Human Resources.

Context: India, despite being one of the fastest-growing economies globally, continues to battle a high burden of tuberculosis (TB). This age-old disease, both preventable and curable, presents a stark contrast to India’s economic progress. The National Strategic Plan (NSP) for Tuberculosis Elimination, set with the goal of eradicating TB by 2025, faces significant hurdles. The Global TB Report 2024 highlights that India accounted for over a quarter of global TB cases in 2023, a situation that underscores the ongoing challenge despite India’s growth.

Current TB Scenario in India:

1. India continues to account for 26% of global TB cases, maintaining the highest share in global TB incidence for almost a decade.
2. As per the World Health Organization (WHO), India is part of all three global High Burden Country lists — TB, TB with HIV, and Multi-Drug Resistant (MDR) TB.
3. The country has seen a steady rise in TB notifications, especially in the years 2017–2024, with a notable dip during the COVID-19 pandemic due to limited healthcare access.
4. The number of medically treated TB cases per 100,000 people has slightly decreased from 305 per 100,000 in 2015-16 to 222 per 100,000 in 2019-21, but the high prevalence persists.

National Strategic Plan for Tuberculosis Elimination (2017-2025):

1. India’s NSP aims to eliminate TB by 2025, five years ahead of the global target of 2030. However, achieving this target seems increasingly ambitious given the current trends.
2. Despite efforts to scale up TB interventions, India is struggling with high TB incidence and mortality, reflecting significant gaps in TB prevention, detection, and care.

Key Challenges in TB Control:

1. Lack of Public Awareness and Misconceptions:  Awareness about TB’s transmission remains limited.
   1. NFHS-5 data reveals that misconceptions about how TB spreads are widespread, including beliefs that TB spreads through sharing utensils or touching a person with TB.
   2. Such misunderstandings lead to inadequate preventive practices and fuel the stigma surrounding TB, causing patients to conceal their diagnosis and reducing reporting and treatment adherence.
2. Stigma and Secrecy:  Stigma is a significant barrier in TB control. Data from NFHS-5 shows that around 15.6% of adult women and 22.9% of men would prefer to keep a TB diagnosis secret. This tendency contributes to underreporting and delays in seeking medical attention, further exacerbating the spread of the disease.
3. Involvement of the Private Sector and Treatment Gaps: Despite India’s free TB care infrastructure through public healthcare facilities, over 25% of TB patients seek treatment exclusively from private healthcare providers.
   1. The private sector often provides suboptimal care, including misdiagnosis and exorbitant treatment costs, pushing patients into “medical poverty.”
   2. Additionally, private TB providers do not always report cases to the government, impeding accurate data collection and effective program implementation.
4. Nutritional Deficiency: Under-nutrition is a major contributor to India’s TB burden. Research indicates that nutritional deficiencies contribute to nearly 35% of the country’s TB burden.
   1. The Ni-kshay Poshan Yojana, launched in 2018, has provided direct nutritional support to over 1.37 crore TB patients, which has helped improve treatment adherence and recovery outcomes.

Innovations and Progress in TB Control:

1. TB Mukt Bharat Abhiyan: The TB Mukt Bharat Abhiyan, launched to accelerate the decline of TB cases, has led to a 21% reduction in TB incidence between 2015 and 2024.
   1. A key factor behind this progress is the shift towards early and proactive detection, including the screening of asymptomatic individuals. This approach has uncovered subclinical TB cases, which are significant contributors to the spread of the disease.
   2. Over 19 crore people have been screened, leading to the detection of over 8.61 lakh asymptomatic cases among the total 24.5 lakh diagnosed TB cases.
   3. India has pioneered the use of AI-enabled handheld X-ray devices for large-scale, rapid screening, especially in underserved areas, including urban slums and remote regions.
2. Community Involvement: The Jan Bhagidari (People’s Participation) approach has been central to the campaign’s success.
   1. Over 2 lakh youth volunteers and 6.77 lakh Ni-kshay Mitras (TB care supporters) have been mobilized to support TB patients.  This has helped reduce stigma and foster community-based care.
   2. Over 15 lakh Ni-kshay Shivirs (community support camps) have been conducted, encouraging active community participation in TB control.
3. Impact of Nutrition on TB Outcomes:  The integration of nutritional support has been another pillar of India’s success. The Ni-kshay Poshan Yojana, which provides financial assistance for nutrition, has been crucial in improving the health and resilience of TB patients.
   1. Nutritional support has improved patient outcomes, treatment adherence, and recovery rates.
   2. Additionally, over 45 lakh nutritious food baskets have been distributed to TB patients through the Ni-kshay Mitra initiative, directly supporting the well-being of affected individuals.

Way Forward

1. Strengthening Awareness and Education: Large-scale awareness campaigns focusing on the correct modes of TB transmission and the importance of early treatment seeking are crucial. The role of the media, celebrities, and TB survivors in reducing stigma and spreading awareness must be amplified.
2. Enhancing Healthcare Access and Regulation: Access to affordable, quality TB care must be enhanced, particularly in rural and underserved areas. The regulation of private healthcare providers and better integration with the public TB control program is essential to ensure all patients receive accurate diagnoses and effective treatments.
3. Increased Investment in TB Research and Technology: India’s commitment to scaling up TB detection through technology, such as AI-based diagnostics and rapid molecular testing, must be expanded. This includes further improving surveillance systems to track and intervene in TB cases earlier. The government must invest in research to develop more effective TB vaccines and drugs, especially for drug-resistant strains.
4. Political Commitment and Funding: For the NSP to succeed, stronger political will, increased funding, and a comprehensive whole-of-government approach are needed. Ensuring equitable allocation of resources between TB and other public health challenges, such as COVID-19, is essential.

Conclusion: India’s TB burden remains one of the world’s highest, but the country has made notable progress in its fight against the disease. Initiatives like the TB Mukt Bharat Abhiyan, strengthened community participation, and nutritional support are driving change. However, significant challenges remain, including stigma, underreporting, and healthcare gaps. To achieve the ambitious goal of TB elimination by 2025, India must continue its innovative approach while expanding access to care, enhancing public awareness, and securing sustained political and financial commitment. Only through a multi-faceted, inclusive approach will India be able to achieve a TB-free future.

Question: Despite significant progress, what are the main challenges India faces in eliminating tuberculosis by 2025?