IAS/UPSC Coaching Institute  

17 Nov 2025 : Swing, but do not miss

 Editorial 2: ​​​Swing, but do not miss

Context

India’s fight against tuberculosis demands fresh urgency and sharper focus.

 

Introduction

India’s fight against tuberculosis (TB) reflects both progress and persistent challenges. While the country achieved the world’s fastest decline in TB incidence, it still accounts for a quarter of global cases. Rising drug-resistant TB, uneven State-wise trends, and lingering mortality gaps highlight why India’s TB elimination target remains unmet despite technological advances and strengthened public health efforts.

 

India’s TB Burden: A Mixed Picture

  • WHO’s Global Tuberculosis Report 2025 presents both progress and persistent challenges for India.
  • TB incidence in India fell by 21%—from 237 per lakh (2015) to 187 per lakh (2024), the fastest decline globally.
  • Despite this, India still accounts for 25% of the world’s TB cases, the highest globally in 2024.

 

State-wise Trends and Prevalence

  • Uttar Pradesh reported the highest number of TB cases, followed by Maharashtra, Bihar, and Madhya Pradesh.
  • Delhi shows the highest prevalence rate, although absolute case numbers are lower.
  • The distribution highlights significant inter-State disparities in detection and spread.

 

The MDR-/RR-TB Challenge

  • India recorded the largest number of multidrug-resistant TB (MDR-TB) cases globally in 2024.
  • It accounted for 32% of global MDR-/RR-TB cases, indicating a severe resistance burden.
  • Treatment success stands at 90% for new TB cases, but only 77% for MDR-/RR-TB patients on second-line therapy.

 

Mortality, Missed Targets, and Gains

  • TB mortality reduced from 28 per lakh (2015) to 21 per lakh (2024).
  • The figure remains over three times higher than India’s elimination target.
  • India missed its goal of eliminating TB by 2025, ahead of the global target of 2030.
  • Nonetheless, steady improvements have led to millions of lives saved over the years.

 

Drivers of Progress and Remaining Gaps

  • Gains are driven by:
    • Adoption of AI tools, molecular diagnostics, and rapid drug-resistance detection.
    • Improved nutrition support for high-risk communities.
    • Newer drug-resistant TB treatment schemes and therapies like BPaLM.
  • Persistent challenges include:
    • Diagnosis gaps, especially in rural regions.
    • Socio-economic inequality affecting treatment access.
    • High MDR-TB burden, drug shortages, and malnutrition.
  • Without tackling these issues decisively, India’s TB elimination efforts may continue to fluctuate between progress and setbacks.

 

Conclusion

India’s TB programme shows promising momentum through AI-driven diagnostics, improved nutrition support, and newer MDR-TB therapies. However, unresolved gaps—rural diagnosis shortages, socio-economic disparities, drug-resistant TB burden, and recurring drug stock-outs—continue to impede elimination. Addressing these barriers with urgency and equity is essential for transforming current gains into a sustainable, nationwide victory over TB.