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India’s Tuberculosis (TB) crisis

Published: 5th Apr, 2024


Despite the government’s commitment to “eliminate high-burden infectious” TB by 2025, ‘India is still far from reaching its goal’. There are six key challenges identified: TB diagnosis and access; lack of access to free, quality treatment and drugs; adequate nutrition and mental health support; stigma-free and gender responsive care; economic support; and high quality care.                                                                                                                                        

1: Dimension- Barriers in India’s progress in combating TB

  • Insufficient diagnosis and treatment access, stigma, and socioeconomic barriers continue to impede India’s progress in combating this disease.
  • Poverty: Socioeconomic conditions create vulnerabilities to the disease.
  • Undernutrition: It is a major risk factor for both the occurrence of new cases and the occurrence of severe TB that can result in TB deaths.
  • Delayed diagnosis, and a lack of access to quality care. 
  • Multi-drug resistance worsens matters.

2: Dimension- The right healthcare intervention

  • Comprehensive care for children: Children constitute 6–7% of all patients treated under the national TB elimination programme
  • Focus on nutrition: The state should immediately focus on increasing the duration and quality of inpatient care, particularly for very severe undernutrition.
  • Effective diagnosis: There is a need to expand diagnostic facilities, include mobile testing units, improve access to molecular testing at affordable prices, and provide quick and accurate results.
  • Addressing social factors: There is a need to address the social factors that aggravate the infection (poverty, stigma, etc).

Tamil Nadu Case Study (state-wide differentiated TB care model)

  • The first published report?of a state-wide differentiated TB care model in Tamil Nadu (TN-KET), in 2023, showed that to reduce TB deaths in resource-limited settings, triaging — quickly examining patients to decide who is most seriously ill and must be treated first — can identify those with the immediate need for comprehensive assessment and inpatient care.
  • Considering 70% of TB deaths happen within the first two months, it is important to triage patients at TB diagnosis.

Fact Box:

World TB Report 2023

  • According to the World TB Report 2023, India recorded an average of 199 new infections in every 100,000 people in 2022.
  • An estimated 13% of treated patients and 2.5% of new cases were multi-drug resistant or resistant to the first-line drug rifampicin.
  • Nearly 400,000 people die of TB each year in the country. 


  • Current biomedical strategies to reduce new infections include the
    • BCG vaccine, which protects against severe forms of childhood TB
    • Tuberculosis preventive treatment (TPT) which aims to cover other household contacts, clinical-risk groups apart from children younger than five years and household contacts with HIV
    • Effective rifamycin-based regimes

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