India’s journey towards tuberculosis (TB) elimination is a globally recognized success story. Between 2015 and 2023, India achieved a 17.7% decline in TB incidence, surpassing the global average decline of 8.3%, as highlighted in the World Health Organization’s Global Tuberculosis Report 2024. This progress underscores the impact of the National Tuberculosis Elimination Programme (NTEP), which is working to meet the ambitious goal of TB elimination by 2025, five years ahead of the UN Sustainable Development Goal (SDG) target of 2030.

India’s TB Elimination Goals

Under SDG Target 3.3, India has committed to achieve the following by 2025:

1. 80% reduction in TB incidence rates (new cases per lakh population) compared to 2015 levels.

2. 90% reduction in TB mortality rates compared to 2015 levels.

3. Zero TB-affected households experiencing catastrophic expenses due to the disease.

This commitment was first articulated by Prime Minister Narendra Modi at the End TB Summit in 2018 and reaffirmed at the One World TB Summit in 2023. India is also a signatory to the Gandhinagar Declaration (2023), pledging regional cooperation to eliminate TB in South-East Asia by 2030.

Strategies and Achievements: The National Tuberculosis Elimination Programme (NTEP)

The NTEP, aligned with the National Strategic Plan (NSP) 2017–2025, intensified its efforts post-COVID-19 to accelerate TB elimination.

Key Achievements in 2023

1. Diagnostic Expansion:

• 1.89 crore sputum smear tests and 68.3 lakh nucleic acid amplification tests (NAATs) conducted.

• Strengthened access to diagnostic services at all levels of healthcare.

2. Improved Treatment for Drug-Resistant TB (DR-TB):

• Rollout of shorter oral regimens to minimize treatment delays.

• Enhanced care quality by addressing coexisting conditions like malnutrition, diabetes, HIV, and substance abuse.

3. Preventive Measures:

• Expanded access to Tuberculosis Preventive Treatment (TPT), benefiting 15 lakh individuals, including those on shorter regimens.

4. Holistic Approach:

• Collaboration with other ministries to tackle conditions affecting TB outcomes, such as malnutrition, diabetes, and HIV, providing comprehensive care packages.

Strengthening Patient Support Systems

1. Ni-kshay Poshan Yojana:

• Direct Benefit Transfer (DBT) scheme that disbursed ₹2,781 crores to over 1 crore beneficiaries for nutritional support.

2. Community Engagement Through PMTBMBA (Pradhan Mantri TB Mukt Bharat Abhiyaan):

• Launched in September 2022, this initiative focused on community ownership in TB elimination efforts.

• Over 1.5 lakh Ni-kshay Mitras (supporters) committed to aiding individuals affected by TB.

3. Incentives for Stakeholders:

• Incentives provided to ASHA workers, TB Vijetas (TB champions), and Ni-kshay SAATHIs (family caregivers) to enhance patient care.

4. Advocacy and Awareness Campaigns:

• Amplified efforts through advocacy, communication, and social mobilization to drive awareness at the community level.

Challenges in Achieving TB Elimination

While India has made remarkable progress, several challenges remain:

1. Undiagnosed and Untreated TB Cases:

• A significant proportion of TB cases remain undiagnosed, particularly in rural and marginalized populations.

2. Drug Resistance:

• The rise in Drug-Resistant TB (DR-TB) complicates treatment and requires additional resources.

3. Social and Economic Burden:

• Many TB-affected households face financial strain despite support programs.

4. Co-Morbid Conditions:

• TB outcomes are often worsened by conditions like malnutrition, diabetes, and HIV.

5. Stigma and Awareness Gaps:

• Stigma surrounding TB continues to hinder early diagnosis and treatment adherence.

The Way Forward: Advancing Towards TB Elimination

To sustain the momentum, India is implementing and developing several interventions:

1. Innovations in Diagnosis and Treatment

• Expansion of molecular diagnostic testing for all suspected cases of TB.

• Scaling up shorter treatment regimens under TPT (Tuberculosis Preventive Therapy).

• Comprehensive recording and reporting mechanisms for effective monitoring.

2. Community-Based Support Systems

• Further decentralization of TB services through “Ayushman Arogya Mandirs.”

• Strengthening initiatives like PMTBMBA to increase community engagement.

3. Research and Development

• Conducting studies on adult BCG vaccination to enhance immunity.

• Fostering research to improve treatment outcomes and develop innovative solutions.

4. Cross-Sector Collaboration

• Continued partnerships with other ministries, NGOs, and the private sector to address co-morbidities and improve patient outcomes.

5. Awareness and Advocacy

• Intensifying communication campaigns to combat stigma and promote early diagnosis and treatment adherence.

India’s commitment to TB elimination is reflected in its robust policy framework, innovative healthcare solutions, and community-driven efforts. With significant declines in incidence and strengthened patient support systems, the country is well-positioned to achieve its ambitious TB-Free India by 2025 target.

 

Through continued focus on cross-sector partnerships, innovative diagnostics, and patient-centered strategies, India is setting an example for the world in tackling tuberculosis and advancing towards global health goals