Context & The Gist
The World Health Organization’s (WHO) Global Tuberculosis Report 2025 reveals a mixed picture for India, showing the highest decline rate in TB incidence globally but also highlighting that India still bears a significant 25% of the world’s TB burden. The article underscores the need for renewed focus and vigour in India’s fight against TB, despite incremental gains made over the past decade.
Key Arguments & Nuances
- Progress in Incidence & Mortality: India has achieved the highest decline rate in TB incidence globally (21% from 2015-2024) and a reduction in mortality rates, but these improvements are insufficient to meet the national elimination target.
- High Burden & Regional Disparities: Despite overall decline, India accounts for the maximum number of TB cases globally, with Uttar Pradesh, Maharashtra, Bihar, and Madhya Pradesh having the highest caseloads, and Delhi exhibiting the highest infection prevalence.
- Challenge of Drug Resistance: India records the highest number of drug-resistant TB (MDR-TB/RR-TB) cases, accounting for 32% of the global total, posing a significant challenge to elimination efforts.
- Treatment Success Rates: While treatment success rates are relatively high for new cases (90%), they are lower for MDR-/RR-TB cases (77%), indicating a need for improved treatment regimens and adherence.
- Factors Contributing to Gains: Advances in technology (AI, molecular diagnostics), improved nutrition, targeted schemes for drug-resistant TB, and newer therapies (BPaLM) have contributed to the observed progress.
UPSC Syllabus Relevance
- GS Paper II: Social Issues – Health: The article directly relates to issues of public health, disease control, and national health programs.
- GS Paper II: Governance – Government Policies & Welfare Schemes: Analysis of the National TB Elimination Programme and its effectiveness.
- GS Paper III: Science & Technology – Developments in Medical Science: The role of AI and newer diagnostic tools in TB control.
Prelims Data Bank
- Global TB Report: Published by the World Health Organization (WHO).
- TB Incidence Decline (India): 21% decline from 2015 to 2024 (from 237 per lakh population to 187 per lakh population).
- India’s TB Burden: Accounts for 25% of the world’s TB cases.
- MDR-TB/RR-TB Cases (India): Accounts for 32% of global cases.
- National TB Elimination Programme (NTEP): Aims to eliminate TB by 2025 (originally), now revised.
- BPaLM: Newer therapy used in TB treatment.
Mains Critical Analysis
India’s TB control program faces a complex interplay of factors. A PESTLE analysis reveals:
- Political: Commitment to elimination targets, policy support for NTEP, inter-sectoral coordination.
- Economic: Funding for NTEP, impact of TB on economic productivity, socio-economic disparities influencing vulnerability.
- Social: Stigma associated with TB, nutritional deficiencies, access to healthcare in rural areas.
- Technological: Adoption of AI and molecular diagnostics, development of new drugs and therapies.
- Legal: Regulations related to TB reporting and treatment, ensuring patient rights.
- Environmental: Overcrowding and poor ventilation contributing to transmission.
The core issue lies in translating incremental gains into a dramatic reduction in TB burden. The critical gap is addressing socio-economic determinants of health, improving diagnosis rates in rural areas, ensuring consistent drug supply, and tackling the rising challenge of drug-resistant TB. The implications of failing to meet elimination targets are significant, including continued morbidity and mortality, economic losses, and potential for further spread of drug-resistant strains.
Value Addition
- High-Level Committee on TB: Established in 2023 to provide strategic guidance to NTEP.
- SC Judgments: Various court rulings emphasizing the right to health and access to TB treatment.
- Best Practice (Indonesia): Indonesia’s success in scaling up active case finding and community-based TB care.
- Quote: “TB is curable and preventable. The challenge is not in what we do not know, but in how we translate knowledge into action.” – Dr. Tedros Adhanom Ghebreyesus, WHO Director-General.
The Way Forward
- Immediate Measure: Strengthen surveillance and diagnostic networks, particularly in high-burden districts, and ensure uninterrupted drug supply.
- Long-term Reform: Address socio-economic determinants of TB, invest in research and development of new diagnostics and therapies, and promote inter-sectoral collaboration (health, nutrition, sanitation).