Eliminating TB – National Health Imperative

By Shri Jagat Prakash Nadda
Honourable Prime Minister Sh. Narendra Modi Ji gave a clarion call for elimination of TB from the country. Under his leadership a new model of TB care was adopted and India pioneered several innovative approaches over the last few years to bring a paradigm shift in TB prevention, diagnosis and treatment. Findings from the WHO’s Global TB Report 2024 acknowledged the efficacy of the approach adopted so far. It noted a 17.7% decline in TB incidence in India from 2015 to 2023 – double the rate of decline observed globally. Not just that, the country diagnosed 25.1 lakh patients, marking a significant rise in treatment coverage within the country from 59% in 2015 to 85% in 2023.

On December 7, inspired by the Prime Minister’s vision, India witnessed yet another transformative push in its TB elimination strategy. The government launched an intensified 100-day nationwide campaign from Panchkula, covering 347 high TB burden districts, to accelerate our response to fight TB. The initiative reinforces our resolve to identify every TB patient early by proactively reaching out to vulnerable populations and by providing them with timely, need-based, and quality treatment. In the true spirit of Jan Bhagidari, all of us – elected representatives, health practitioners, civil society, corporates, and communities – collaborated to make the campaign a grand success.

With the proactive collaboration of States and Union Territories, this new campaign promises to be yet another milestone in India’s TB elimination journey.

India’s social approach to TB elimination

To complement expanded diagnostic efforts and to support a complete recovery of the TB patients, India conceptualised and operationalised a nutritional support scheme – Ni-kshay Poshan Yojana (NPY). Since April 2018, we have disbursed ₹3,295 crores to 1.16 crore beneficiaries through Direct Benefit Transfer under NPY. In what is a major reinforcement of India’s commitment to TB elimination, the monthly support under the scheme has been doubled from the existing ₹500 to ₹1,000 per month from November 2024.

Another critical aspect – the TB Mukt Bharat Abhiyaan has not only helped in addressing the challenge of nutrition but also enhanced community mobilization. The program has also united various community stakeholders creating a mass movement to increase awareness and to provide nutritional, vocational, and psychological support to TB patients. This government-citizen symphony anchored in the spirit of Jan Bhagidari has inspired 1.75 lakh Ni-kshay Mitras to provide 21 lakh food baskets to patients across the country.

Driving innovation to end TB

Over the years, India has introduced newer drugs such as Bedaquiline and Delamanid to improve treatment success rates. Considering the challenges in treatment completion for patients with the drug-resistant variant, we have allowed a new shorter regimen – BPaLM which is more effective than the existing regimens. While we have a shorter 9–11month regimen available alongside the conventional 19–20 month regimen, with the BPaLM regimen patients will now complete treatment in just six months!

We have consistently strived to ensure that advanced tools are available at the grassroot levels to find and treat all patients at the earliest. To enable this, we introduced more efficient and accurate diagnostic tools – molecular tests. From a few hundred machines in 2014-15, we now have 8,293 molecular diagnostic machines available in all districts.

In fact, taking a cue from the ‘Make in India’ initiative, indigenous molecular tests have been field-tested and introduced. We have been able to not only reduce the time taken for TB diagnosis at district and block levels but have drastically reduced the costs of testing and treatment. Our indigenous molecular tests have received endorsement by the World Health Organisation and are being utilized across the world. These initiatives have positioned India as a true leader in the global TB response.

We must also take great pride in the fact that the Indian Council of Medical Research (ICMR) has consistently been among the top public funders of TB research worldwide since 2018[2]. We will continue making investments to quickly develop and roll out newer tools, including more efficient point-of-care diagnostics.

Looking Ahead

India’s journey toward TB elimination is a testament to its leadership in spurring innovation across various sectors and making available proven technologies in an accelerated manner. From pioneering research that has led to advanced diagnostics and treatments, to the introduction of universal social support provisions, India stands at the forefront of the global TB response. The need of the hour is to ensure a massive Jan Bhagidari in identification, diagnosis, treatment and prevention of TB. The intensified 100-day campaign is a further testament to our collective commitment to eliminate TB. I am confident that under the leadership of our Honourable Prime Minister and with the participation of all stakeholders, we will defeat this great enemy of humanity and create a healthier future for all.