TB-free India is a distant goal as national plan struggles to meet targets

Country's share in global TB burden narrowed from 27% in 2015 to 25% in 2024 but it still has the most cases in the world

Devdas, the tragic protagonist of at least two Hindi movies based on Sarat Chandra Chattopadhyay’s Bengali novel, suffers from and eventually succumbs to tuberculosis. This illness fuels his self-destructive path and separation from his love, Paro. The movies use TB as a metaphor for decay and sorrow in a country where the bacterial disease is a highly relatable and relevant public health issue.

 

India’s share in the global TB burden narrowed from 27 per cent in 2015 to 25 per cent in 2024 but it still has the most cases in the world (one in four), according to the Global Tuberculosis Report 2025 by the World Health Organization (WHO).

 

The WHO’s End TB Strategy seeks a 50 per cent case reduction and a 75 per cent decrease in TB deaths by 2025 from 2015 numbers. India’s own targets are even more ambitious. It launched the National TB Elimination Programme in 2020 to end the disease by 2025, five years ahead of the global target of 2030. The programme targets an 80 per cent drop in TB cases and 90 per cent decrease in mortality, with 2015 as the baseline year.

 

However, from 2015 to 2024, India has managed a 21 per cent reduction in incidence and a 28 per cent fall in TB deaths, failing to meet even half of the global targets.

 

India’s TB incidence rate (per 1,00,000 population) declined from 236.7 in 2015 to 186.6 in 2024. The share of multi-drug resistant TB in all TB cases inched up from 14.33 per cent in 2015 to 16.27 per cent in 2024. Better tracking of unreported cases has improved TB case notification rate (the number of TB cases that have been officially diagnosed, registered, and reported to national health authorities.

 

“Under-nutrition remained the single largest risk factor for developing active TB in India, contributing to nearly 35 per cent of the country’s TB burden,” said a government press statement earlier this week. A recent study by the Indian Council of Medical Research corroborated the role of nutrition in reducing TB cases and fatalities.

 

Diabetes is the second biggest risk factor for TB, followed by alcohol-use disorders, smoking and Human Immunodeficiency Virus. Empirical studies show that air pollution is a major contributing factor in fastening TB-related mortality.  

 

Funds available to India for preventing, diagnosing and treating TB in 2024 increased by 59 per cent from the previous year to reach over $480 million.

 

However, the share of international funding in India’s corpus declined from 51.82 per cent in 2021 to 9.19 per cent in 2024. After the end of Covid-19, international funds have largely gone to prevent and treat that disease, reducing funds for eradicating TB.

 

India’s pace of reduction in TB incidence (21 per cent) was one of the best; it is almost double the global average of 12 per cent. However, the progress seems modest against lofty national and global targets.