India's Tuberculosis Report Highlights Challenges

Summary of India's Tuberculosis (TB) Situation from WHO Global Tuberculosis Report 2025

1. TB Incidence and Global Context:

• Incidence Decline: India saw a 21% decline in TB incidence from 237 per lakh population in 2015 to 187 per lakh population in 2024.
• Global Burden: India holds 25% of the world's TB burden and recorded the highest number of TB cases in 2024.
• Geographic Distribution:
  • Highest Cases: Uttar Pradesh > Maharashtra > Bihar > Madhya Pradesh.
  • Prevalence Rate: Delhi has the highest prevalence, although case numbers are lower than in other states.

2. Multidrug-Resistant TB (MDR-TB):

• Global Impact: India recorded 32% of global MDR-TB and rifampicin-resistant TB cases in 2024.
• Treatment Success Rates:
  • New and treated cases: ~90%.
  • MDR-/RR-TB (second-line treatment): 77%.

3. Mortality Rate:

• Drop in Mortality: Decreased from 28 deaths per lakh population in 2015 to 21 per lakh in 2024. However, this remains over three times higher than the government’s elimination target.

4. Indian Government's Targets and Challenges:

• Elimination Target: Aim to eliminate TB by 2025 (5 years ahead of the global target of 2030).
• Missed Targets: Despite incremental gains, India has not met its elimination target.

5. Contributions to Improvement:

• Technological Advancements:
  • Use of AI and newer tools for molecular diagnosis and rapid detection.
• Nutrition Focus: Improved nutrition strategies to support vulnerable populations against TB.
• Drug-Resistant TB Scheme: Introduction of specialized programs for MDR-TB, including newer treatment regimes like BPaLM.

6. National TB Elimination Programme:

• Future Directions: The National TB Elimination Programme emphasizes progressive strategies but faces hurdles:
  • Diagnosis Gaps: Major issues in rural areas.
  • Socio-economic Disparities: Addressing inequities affecting TB spread and treatment.
  • MDR-/RR-TB Burden: High incidence of drug-resistant TB.
  • Drug Availability: Frequent shortages leading to treatment delays.
  • Malnutrition: Addressing poor nutrition levels that predispose populations to TB infection.

This report outlines significant progress in India’s TB control efforts while highlighting the persistent challenges that require focused interventions.