Closing In On TB

Despite India’s progress in TB elimination, diagnostic gaps, subclinical cases, and high mortality remain major barriers. The article highlights how technology, innovation, and public health strategies can bridge these gaps and make TB elimination a reality by 2025.

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Context

  • Despite India’s progress in TB elimination, diagnostic gaps, subclinical cases, and high mortality remain major barriers. The article highlights how technology, innovation, and public health strategies can bridge these gaps and make TB elimination a reality by 2025.

Background

  • India has the world’s highest burden of tuberculosis (TB), with ongoing efforts under the National Tuberculosis Elimination Programme (NTEP) to eliminate TB by 2025.  
  • The WHO Global TB Report 2024 notes a global 8.3% reduction in TB incidence (2015–2023); India surpassed this with a 17.7% decline. 
  • The COVID-19 vaccine success model offers lessons for TB vaccine development — global collaboration, strong public funding, and regulatory efficiency. 

Initiatives

  • The National Tuberculosis Elimination Programme (NTEP) aims to eliminate TB in India by 2025, targeting an 80% reduction in incidence, 90% reduction in TB deaths, and zero catastrophic costs for patients.
  • Guided by the National Strategic Plan (2017–2025), it follows the DTPB strategy—Detect, Treat, Prevent, and Build. 
  • The programme aligns with the WHO End TB Strategy and the UN Sustainable Development Goals (SDGs) to end TB as a public health threat. 
  • 100-day TB Mukt Bharat Abhiyaan: Identified 2.85 lakh asymptomatic TB cases using tech-enabled screening.  Nikshay Poshan Yojana (NPY): Monthly nutritional support for TB patients doubled
  • Indian Council of Medical Research (ICMR): Facilitating adoption of non-invasive diagnostics like nasal/tongue swabs and open PCR platforms. 
  • mRNA TB Vaccine: In early-stage development in india, with other candidate in clinical trials

Challenges Highlighted

  • Diagnostic Gap: In 2023, 2.7 million TB cases globally went undiagnosed. Conventional symptom-based screening misses subclinical TB, which may account for 50% of total cases in high-burden countries like India. 
  • Technology Gaps in Rural Diagnostics: Portable chest X-rays and AI-assisted readings are not yet universally accessible. 
  • Sputum-based tests are hard for vulnerable groups like children and the elderly. 
  • Undernutrition as a Key Risk Factor: Undernutrition is a leading contributor to TB progression. Despite efforts, food insecurity remains prevalent among TB-affected households.  
  • High Mortality Among High-Risk TB Patients: Lack of differentiated care models leads to late referrals and inadequate inpatient treatment


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