India’s TB crisis

THE latest ‘Global Tuberculosis Report’ by the WHO paints a bleak picture for India, which now accounts for 26 per cent of the world’s TB cases. This statistic alone underscores the challenges facing India’s National TB Elimination Programme, set against a backdrop of rising multidrug-resistant tuberculosis (MDR-TB), a public health crisis in its own right. India recorded 2.55 million new TB cases in 2023, its highest since TB monitoring began in the 1960s. MDR-TB complicates the situation further, with India housing the largest global burden. MDR-TB, resistant to essential drugs like isoniazid and rifampin, often arises from treatment mismanagement and requires longer, costlier and more toxic medications.

Unfortunately, only 44 per cent of the MDR-TB cases receive adequate treatment. This stark gap reveals the strain on India’s health infrastructure and the impact on patients whose access to quality care remains inconsistent. Despite a nearly 90 per cent treatment coverage rate, the costs of treating and managing TB are catastrophic for many households in India. Around 20 per cent of the patients face expenses that exceed 20 per cent of their annual income. Moreover, funding for TB has dwindled by over $130 million in recent years, putting India’s ambitious goal of eliminating TB by 2025 increasingly out of reach.

Reaching this goal will require more than improved diagnostics and treatment coverage. The government must bridge funding gaps and tackle the socio-economic factors driving TB, including poverty, undernutrition and limited healthcare access. Furthermore, increasing awareness about MDR-TB and expanding the use of newer treatment regimens, like the BPaLM, could be game-changers. The TB crisis makes urgent action imperative. Without robust investment and coordinated efforts, TB will continue to thwart India’s health goals and global ambitions. For the world, defeating TB isn’t just a matter of health; it’s a test of our shared commitment to tackling one of humanity’s oldest and deadliest diseases.