Tuberculosis incidence falling in India by 21% a year: WHO report
Table of Contents
Sources: The Hindu
Relevance: GS Paper III
Key Concepts for Prelims and Mains:
For Prelims:
Tuberculosis (TB), Pulmonary TB, Extrapulmonary TB (EPTB), Ni-kshay Poshan Yojana (NPY)
For Mains:
India’s 21% TB incidence reduction: significance, Challenges in TB elimination: MDR-TB, nutrition, private sector integration, Governance reforms for TB-Free India by 2025Why in News?
The WHO Global TB Report 2025 shows that India’s TB incidence has declined by 21% between 2015 and 2024 — from 237/lakh to 187/lakh, almost double the global decline (12%). It is one of the highest reductions among high-burden countries.
1. What is TB?
Tuberculosis (TB) is a contagious airborne disease caused mainly by Mycobacterium tuberculosis.
It usually affects the lungs, but can also impact other organs such as the brain, bones, kidneys, and lymph nodes.
2. How TB Spreads
TB spreads through the air when an infected person with lung TB coughs, sneezes, talks, or spits, releasing infectious droplets.Even inhaling a few bacteria can cause infection.
TB is preventable and curable with proper treatment.
3. Types of TB
(A) Pulmonary TB
- Affects the lungs.
- Most common and highly contagious.
- Spreads through infected airborne droplets.
(B) Extrapulmonary TB (EPTB)
- Occurs outside the lungs.
- May affect the lymph nodes, bones, brain, kidneys, or pleura.
- Less contagious and usually spreads within the body.
Key Findings of the Recent WHO Report
1.TB Incidence Decline: 21% Reduction
- 2015: 237 cases per lakh
- 2024: 187 cases per lakh
- Overall decline: 21%, compared to global decline of 12%
This sharp fall is described as one of the highest incidence reductions among high-TB-burden countries.
2. Major Factors Behind India’s Progress
The Ministry attributes the decline to:
a) Innovative Case-Finding Approaches
- Active surveillance
- Targeted screening of high-risk groups
b) Uptake of Newer Technologies
- Adoption of modern diagnostic tools
- Improved reporting systems
c) Decentralisation of TB Services
- Easier access at district and sub-district levels
d) Community Mobilisation
- Volunteers and community health workers helped raise awareness and trace cases
Impact:
Treatment coverage increased from 53% in 2015 to over 92% in 2024.
In 2024:
- 26.18 lakh patients were diagnosed
- Out of an estimated 27 lakh TB cases
3. Reduction in “Missing Cases”
“Missing cases” refer to people who have TB but are not reported to the national programme.
- 2015: 15 lakh missing cases
- 2024: Less than 1 lakh
This signifies:
- Stronger surveillance
- Better integration of private sector reporting
- Wider screening coverage
4. Stable MDR-TB Situation
The report highlights no significant rise in the number of multidrug-resistant tuberculosis (MDR-TB) patients in India.
- Indicates controlled drug resistance
- Reflects improved treatment adherence and drug quality assurance
5. Rising Treatment Success Rate
Under the TB Mukt Bharat Abhiyan, India achieved:
- 90% treatment success rate, higher than the global rate of 88%
This improvement is attributed to:
- Timely treatment initiation
- Strong follow-up mechanisms
- Community-based support
6. Decline in TB Mortality
India’s TB-related deaths have also declined:
- 2015: 28 deaths per lakh
- 2024: 21 deaths per lakh
A clear indicator of:
- Better diagnosis
- Stronger treatment outcomes
- Reduced catastrophic delays in care
Major National Initiatives Under India’s TB Elimination Strategy
1. Pradhan Mantri TB Mukt Bharat Abhiyan (PMTBMBA)
- Mobilises community and corporate support for nutrition and diagnostics.
- Largest global crowdsourced nutrition initiative for TB patients.
2. Ni-kshay Poshan Yojana (NPY)
- Nutritional assistance of ₹1,000/month (₹3,000–₹6,000 per patient).
- EDNS supplements for underweight patients (BMI <18.5).
- Over ₹3,202 crore disbursed to 1.13 crore beneficiaries.
3. Ni-kshay Mitra Initiative
- Individuals/NGOs/corporates adopt TB patients for six months.
- Support extended to household contacts to reduce infection risk.
- 2.59 lakh Mitras and 1.18 crore commitments fulfilled (2025).
4. Ni-kshay Portal
- India’s digital TB surveillance and patient management system.
- Enables case registration, DBT tracking, diagnostics, drug management, and adherence monitoring.
Tuberculosis (TB):
- Causative Agent & Transmission
- Caused by Mycobacterium tuberculosis.
- Primarily affects lungs (pulmonary TB) but can affect any organ.
- Spread occurs through airborne droplets when an infected person coughs/sneezes/spits.
- Very few inhaled germs are enough for infection.
- Global Burden
- 10 million new TB cases annually.
- 1.5 million deaths/year → world’s leading infectious killer.
- TB is the leading cause of death among people with HIV.
- Major contributor to antimicrobial resistance (AMR).
- Nearly 50% of global TB cases occur in 8 countries:
Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines, South Africa.
- TB Infection vs TB Disease
Latent TB Infection (LTBI)
- Bacteria remain inactive in the body.
- No symptoms and not infectious.
- About 25% of global population has LTBI.
- Lifetime risk of developing TB disease: 5–10% (higher in HIV, diabetes, malnutrition, tobacco use).
TB Disease
- Active, symptomatic and infectious (pulmonary).
- Common symptoms: prolonged cough, fever, night sweats, weight loss, fatigue, chest pain.
- Symptoms often mild initially → delays care → higher transmission.
- Diagnosis
- WHO recommends rapid molecular diagnostic tests as the first-line test.
(e.g., CB-NAAT / GeneXpert). - Other tools: sputum smear microscopy, chest X-ray.
- For extrapulmonary TB: testing of tissue/body fluids.
- LTBI detected via skin test (Mantoux) or blood test (IGRA).
- Treatment
Drug-Sensitive TB
- Treated with 4 antibiotics for 6 months.
- Key drugs: Rifampicin, Isoniazid (plus Pyrazinamide, Ethambutol).
Drug-Resistant TB (DR-TB)
- Occurs when bacteria do not respond to first-line drugs.
- Treatment is longer, costlier, more toxic.
- Poor adherence increases risk of MDR-TB.
Support System
- Treatment given under supervision and counselling by trained workers to ensure adherence.
Preventive Treatment
- For TB infection (latent TB):
- Shortened regimens: 1-month or 3-month courses (earlier 6 months).
UPSC PYQ
Q1. Which one of the following antimicrobial drugs is suitable for the treatment of both tuberculosis and leprosy? UPSC/1995
(a) Isoniazid
(b) p-aminosalicylic acid
(c) Streptomycin
(d) Rifampicin
Correct Answer: (d) Rifampicin
CARE MCQ
- Consider the following organs
- Lymph nodes
- Bones
- Brain
- Kidneys
- Pleura
- Lungs
How many of the above can be affected in Extrapulmonary TB (EPTB)?
(a) Only three
(b) Only four
(c) Only five
(d) All six
Correct Answer: (c) Only five
Explanation:
- EPTB affects organs outside the lungs, such as:
✔ Lymph nodes
✔ Bones
✔ Brain
✔ Kidneys
✔ Pleura - Lungs are not part of EPTB (they belong to Pulmonary TB).
