India Reports Highest Tuberculosis Cases in 2024 Amid Progress in TB Control

India has recorded its highest-ever number of tuberculosis (TB) cases in 2024, with 26.07 lakh cases, according to Union Minister of State for Health and Family Welfare, Anupriya Patel. This follows a rising trend from 2023, which saw 25.5 lakh cases. Despite this surge, India has made significant strides in TB control, as incidence and mortality rates have shown a notable decline. Patel highlighted these developments at the India Innovation Summit, where she also outlined key initiatives aimed at eradicating TB from the country.

Rising TB Cases Amid Declining Incidence and Mortality Rates

While TB cases have increased in absolute numbers, the incidence rate has seen a 17.7% decline—from 237 cases per lakh in 2015 to 195 per lakh in 2023. TB-related deaths have also reduced by 21.4% in the same period. This suggests that while more cases are being detected and reported, effective interventions are successfully reducing the spread and fatality of the disease.

A significant achievement in India’s TB control efforts has been the reduction in ‘missing TB cases’—undiagnosed or unreported cases that contribute to the silent spread of the disease. These cases have declined from 15 lakh in 2015 to 2.5 lakh in 2023. This improvement can be attributed to aggressive case-finding initiatives, better diagnostics, and increased public awareness.

Expansion of TB Treatment and Coverage

India has dramatically increased its TB treatment coverage from 53% in 2015 to 85% in 2023. This means that a larger proportion of TB patients are now receiving proper diagnosis and treatment, reducing the likelihood of transmission and drug resistance. The government’s efforts in expanding treatment access include introducing improved regimens and innovative diagnostic tools.

Government Initiatives to Combat TB

To address the TB burden, the Indian government has rolled out multiple initiatives to improve treatment, diagnosis, and community support. These include:

1. Improved Drug-Resistant TB Treatment: The introduction of a shorter and safer oral drug regimen with Bedaquiline has increased treatment success rates from 68% in 2020 to 75% in 2022. This marks a major improvement in managing drug-resistant TB cases, which are often the most challenging to treat.
2. Advanced Treatment for Drug-Resistant TB (mBPaL Regimen): This innovative therapy is 80% more effective and significantly shortens the treatment duration to just six months. Shorter treatment periods reduce patient dropouts and improve adherence.
3. Nutritional Support for TB Patients: The Ni-kshay Poshan Yojana has doubled the financial aid given to TB patients from Rs 500 to Rs 1,000 per month, effective November 1, 2024. Proper nutrition is crucial for TB recovery, and this initiative helps ensure that patients receive adequate support.
4. Community Support through Ni-kshay Mitra Initiative: This program mobilizes community participation by encouraging individuals and organizations to ‘adopt’ TB patients, providing them with essential food baskets and financial assistance. This support helps reduce stigma and ensures that patients adhere to their treatment regimens.
5. TB Mukt Bharat 100 Days Intensified Campaign: Launched on December 7, 2024, this campaign covers 455 districts and focuses on early diagnosis, active case finding, and nutritional support for patients. This large-scale initiative is expected to significantly boost TB detection and control efforts across the country.

Technological Innovations in TB Diagnosis

To enhance TB detection and diagnosis, the Indian Council of Medical Research (ICMR) has developed several innovations. These include:

1. Handheld X-ray Devices: Portable X-ray machines now enable TB screening in remote and underserved areas. These devices have low radiation exposure and are highly effective in identifying TB cases early.
2. AI-Powered Chest X-ray Analysis (DeepCXR): Developed with the Institute of Plasma Research in Ahmedabad, this AI-based tool speeds up TB detection and improves accuracy. AI-based diagnosis is particularly useful in rural areas where specialist radiologists are not always available.
3. CyTb Skin Test for Latent TB: This low-cost alternative to the expensive IGRA test helps detect latent TB infections. Early identification of latent TB cases can prevent active disease and further transmission.
4. PathoDetectTM NAAT Test: This molecular test can detect TB and drug resistance simultaneously, making it faster and more efficient than traditional methods. Early detection of drug-resistant strains is crucial for effective treatment planning.
5. Quantiplus MTB FAST Detection Kit: A new low-cost RT-PCR test developed in India, offering 86% sensitivity and 96% specificity. This innovation makes TB testing more accessible and affordable.

India’s Commitment to Disease Eradication

During the summit, Dr. V.K. Paul, Member of NITI Aayog (Health), reaffirmed India’s commitment to eliminating five major diseases in the next five years: Leprosy, Lymphatic Filariasis, Measles, Rubella, and Kala-azar. He also stressed the role of AI in TB detection and the need for scalable innovations that can be deployed nationwide.

Dr. Rajiv Bahl, Director General of ICMR, emphasized that India is actively developing more accurate diagnostics, better treatment options, and AI-driven tools to strengthen TB control efforts. The goal is to make TB detection and treatment faster, more efficient, and widely accessible.

Challenges in TB Control

Despite India’s achievements in TB control, several challenges remain:

1. High Transmission Rates: While treatment success has improved, TB remains highly contagious, particularly in densely populated urban areas. Poor ventilation, overcrowding, and lack of awareness contribute to the rapid spread of the disease.
2. Drug Resistance: The emergence of multi-drug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) poses a significant challenge. While new regimens like mBPaL show promise, ensuring adherence and access remains crucial.
3. Healthcare Infrastructure: While India has made significant progress, rural and underprivileged areas still struggle with inadequate healthcare facilities. Ensuring that new diagnostic tools and treatments reach these areas is vital.
4. Stigma and Social Barriers: TB patients often face discrimination, leading to delayed diagnosis and treatment non-adherence. Community engagement initiatives like Ni-kshay Mitra aim to address this issue, but more awareness campaigns are needed.
5. Co-infections with HIV and Diabetes: Many TB patients also suffer from co-infections like HIV and diabetes, complicating treatment outcomes. Integrated healthcare approaches are required to manage these conditions effectively.

The Road Ahead

India’s ambitious TB Mukt Bharat campaign, along with technological advancements and increased financial aid, marks a significant step forward in TB control. However, continued efforts are needed to address existing challenges, expand treatment coverage, and improve awareness.

The progress report of the TB Mukt Bharat campaign will be released on World TB Day, March 24, 2025. This report is expected to provide further insights into the effectiveness of current strategies and outline future directions.

India has made remarkable progress in its fight against tuberculosis, but the rising number of reported cases indicates the need for sustained and enhanced efforts. The government’s multi-pronged approach—incorporating improved diagnostics, innovative treatments, financial aid, and community participation—has laid a strong foundation for TB elimination. With continued commitment and innovation, India can move closer to achieving its goal of a TB-free nation by 2025.