Apr 1997๐ Backgroundtap to expand
RNTCP launched as DOTS
The Revised National TB Control Programme rolls out Directly Observed Treatment Short-course nationally, becoming the world's largest TB programme.
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India's TB elimination mission: world's highest burden, new drugs, and a missed 2025 deadline
India has 27 percent of the world's tuberculosis cases and 36 percent of global TB deaths. PM Modi pledged elimination by 2025. The deadline has passed. Here's what happened and what comes next.
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India and TB at a glance
Tuberculosis remains India's deadliest infectious disease. The WHO Global TB Report 2024 estimates around 28 lakh Indian TB cases and over 3.4 lakh TB deaths in a single year, making the country home to roughly 27 percent of all TB and 36 percent of global TB deaths. In 2018 the prime minister pledged that India would eliminate TB by 2025, five years ahead of the SDG target. The deadline has now passed without elimination but with real progress. Case notifications crossed 25 lakh in 2023, the highest ever, and the new BPaL regimen has cut treatment for drug-resistant TB from 18 months to 6 months in pilot districts. Mortality has fallen by close to a quarter since 2015. The unfinished agenda is malnutrition, undiagnosed cases in the private sector and persistent resistance, all of which keep India the world's largest TB country well into the late 2020s.
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Why India still has so much TB
TB in India is sustained by a stacking of risk factors. Malnutrition is the largest single driver. ICMR estimates that about half of all new TB cases in India are linked to undernutrition, which weakens cell-mediated immunity. Crowded urban housing, poor ventilation and indoor cooking smoke help the bacterium spread between family members. Diabetes triples TB risk and India now has 10 crore diabetics. The private sector handles half of all suspected TB consultations but until 2017 did not have to notify cases, so millions of patients were treated informally with incomplete drug courses, breeding resistance. HIV co-infection, smoking, alcohol and silicosis add further layers. Finally, India's public health workforce in tribal and remote districts is thin, so case finding and contact tracing depend on outreach by ASHA workers and community volunteers. Without addressing all these social drivers, the bacterium will continue to find new hosts even as drugs improve.
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India's TB epidemic in hard numbers
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