TB remains India's top infectious killer, deadlier than HIV or malaria

Despite decades of control efforts, tuberculosis still causes far more deaths than HIV or malaria, hitting India's working-age population the hardest

Tuberculosis continues to be India’s leading infectious killer, responsible for 2.5 per cent of all deaths between 2021 and 2023—far higher than malaria or HIV, which together accounted for just 0.2 per cent. According to the Sample Registration System’s Causes of Death Statistics 2021–2023, TB deaths peaked at 3.2 per cent among adults aged 30–69, striking hardest during India’s most economically productive years.

Why does TB still linger despite control efforts?

India has been running TB control programmes since the 1960s, yet the disease persists. Experts point to three primary reasons: 

• Poverty and inequity: TB disproportionately affects those living in crowded conditions with poor nutrition and inadequate healthcare access. 
• Antimicrobial resistance (AMR): Drug-resistant TB (DR-TB) is rising, making treatment longer, costlier, and less effective. 
• Post-Covid setbacks: The pandemic disrupted TB diagnosis and treatment, allowing cases to spread and relapses to rise.

TB strikes hardest in working-age adults 

Unlike cardiovascular disease or cancer—which dominate among older adults—TB disproportionately affects people aged 30 to 69, India’s core working population. This makes TB not just a health challenge, but an economic one, as it erodes the workforce and productivity.

 

Progress is visible, but far from enough

India’s National Tuberculosis Elimination Programme (NTEP) has expanded free diagnostic services, introduced newer drugs like bedaquiline, and rolled out nutritional support. The government aims to eliminate TB by 2025, but the SRS data shows that progress remains insufficient to meet that goal.

What must India do to beat TB?

Experts say that defeating TB requires a multi-pronged strategy, including:

• Tackling poverty and malnutrition, which increase vulnerability 
• Scaling up rapid testing and community-based screening 
• Expanding access to new-generation drugs while combating drug resistance 
• Strengthening healthcare systems post-Covid to prevent future disruptions

Despite decades of programmes, TB continues to kill more Indians than any other infectious disease. The latest government data makes it clear: unless India tackles the disease through better healthcare, equity, and AMR resistance, TB will persist—and so will preventable deaths. 

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This content is for informational purposes only and is not a substitute for professional medical advice.