According to the WHO Global TB Report 2025, India has achieved a 21% decline in tuberculosis incidence between 2015 and 2024.

Key Findings of the Report

Global Trends

• Global health challenge: In 2024, 10.7 million people fell ill with TB and 1.23 million died. TB continues to be among the top 10 killers globally and remains the leading infectious disease cause of death. 
• High-burden concentration: 30 countries account for 87% of cases. India, Indonesia, Philippines, China, Pakistan, Nigeria, DR Congo, and Bangladesh together contribute 67%
• Success stories: African and European regions achieved major reductions in mortality (46% and 49%, respectively). Over 100 countries saw ≥20% incidence decline. 
• Threats to Progress: Despite improvements, funding gaps and inequitable access to diagnosis and treatment threaten global TB control efforts.
• Financing Gap: In 2024, only $5.9 billion was available for global TB prevention and treatment — far below the $22 billion target for 2027.
• R&D Lag: Funding for TB research reached $1.2 billion in 2023, just 24% of what is required.

India Specific Trends

• Incidence Rate: India recorded a 21% decline in TB incidence, from 237 per lakh (2015) to 187 per lakh (2024), nearly double the global decline rate.
  • Global Comparison: India’s pace of decline outperformed the global decline of 12% during the same period.
  • Largest Global Burden: Despite this success, India still accounts for 25% of the world’s TB cases, the highest in absolute numbers.
• Mortality Rate: TB mortality decreased from 28 per lakh population (2015) to 21 per lakh (2024), indicating significant improvement in reducing TB-related deaths.
• Treatment Coverage: Coverage rose from 53% in 2015 to over 92% in 2024 due to decentralised services, community mobilisation, and new technologies.
• Missing Cases: The number of unreported or undetected TB cases reduced sharply from 15 lakh (2015) to less than one lakh (2024).
• State-wise Distribution: Uttar Pradesh has the highest number of TB cases, followed by Maharashtra, Bihar, and Madhya Pradesh. Delhi records the highest infection prevalence rate.

Initiatives to Reduce TB

Global Level

• End TB Strategy by WHO (2015–2035): It  aims for a 90% reduction in TB deaths and 80% reduction in incidence by 2030, alongside zero catastrophic costs for affected families.
• Global Fund & Stop TB Partnership: The Global Fund and Stop TB Partnership support financial mobilization, private-sector collaboration, and cross-border TB surveillance, especially in low-income regions.
• New WHO Guidelines (2024–25): WHO has introduced updated protocols for rapid diagnosis, shorter MDR-TB drug regimens, and integrated management of TB–diabetes comorbidity to enhance treatment outcomes.

India Level

• National Tuberculosis Elimination Programme (NTEP): India is implementing the NTEP, which aims to eliminate TB by 2025, aligning with the global End TB Strategy after revising its earlier national deadline of 2025.
• Largest TB Diagnostic Network: India has built 9,391 rapid molecular testing facilities and 107 culture and drug susceptibility testing laboratories.
• AI-Enabled Screening: Over 500 AI-enabled hand-held chest X-ray units are currently deployed, with 1,500 more being delivered to States/UTs.
• Decentralised TB Care: Through 1.78 lakh Ayushman Arogya Mandirs, TB services have been taken closer to communities.
• Nutritional Support Expansion: Under Ni-kshay Poshan Yojana, DBT support was increased from ₹500 to ₹1,000 per month for the entire treatment duration.
• TB Mukt Bharat Abhiyan:
• • Launch & Reach: Launched in December 2024, the mission has screened over 19 crore vulnerable individuals.
  • Case Detection: The initiative has led to the identification of 24.5 lakh TB patients, including 8.61 lakh asymptomatic cases.
• Role of ASHA Workers: ASHA workers have been trained to identify early warning signs and ensure early referral for diagnosis and care.

Challenges in TB Reduction

• Funding Gaps: In 2024, global TB funding stood at $5.9 billion, just one-quarter of the $22 billion annual target set for 2027.
  • Research Underfunded: Funding for TB research was $1.2 billion in 2023, only 24% of the target.
• Missed Target: India aimed to eliminate TB by 2025, ahead of the global target of 2030, but has missed this goal.
• Highest MDR/RR-TB Numbers: India reported the largest number of drug-resistant TB cases globally, contributing 32% of global MDR-TB and RR-TB cases in 2024.
• Infrastructure Gaps: Rural areas face weak healthcare infrastructure, affecting diagnosis and continuity of care.
• Socio-Economic Barriers: Poverty, malnutrition, and stigma hinder timely testing and treatment adherence.
• Supply Chain Issues: Reports have highlighted stockouts of anti-TB drugs in multiple States, forcing patients to skip doses, though central authorities deny a nationwide shortage.
• Human Resource Shortage: Lack of adequately trained personnel in TB surveillance and care slows last-mile delivery.

Why India Missed the 2025 Elimination Target

• Slow Progress vs End TB Milestones: India has made progress but not at the scale required to meet the 2025 elimination goals. 
  • While the End TB Strategy demanded a 50% decline in incidence and 75% reduction in deaths by 2025, India achieved only a 21% decline in incidence and 28% reduction in mortality between 2015 and 2024.
• Large Absolute Disease Burden: India’s huge population and persistent vulnerability mean that even with 92% treatment coverage, the absolute number of cases remains very high, with 26.18 lakh TB cases diagnosed in 2024, the highest ever, making India the top global contributor to TB.
• Contribution to Global Diagnosis Gap: India accounts for 8.8% of the global gap in TB diagnosis, second only to Indonesia, indicating that the last-mile detection of cases is still not comprehensive in high-burden pockets.
• High MDR/RR-TB Burden: India continues to report one-third of the world’s drug-resistant TB, with 1.27 lakh MDR-TB- and rifampicin-resistant (MDR/RR-TB) cases notified in 2024, showing persistent resistance transmission and suboptimal treatment outcomes.
• COVID-19 Disruption Impact: The COVID-19 pandemic diverted TB programme resources to emergency care, which caused disruption in diagnostics, drug adherence, and follow-ups between 2020 and 2022, pushing India off the elimination trajectory.
• Supply Chain and Drug Shortages: Frequent shortages of key TB drugs were reported in multiple states during 2024, and treatment interruptions have aggravated disease transmission and reinforced drug resistance patterns.

Recommendations

• Strengthen Primary Healthcare and Surveillance: India must increase investments in PHC networks, upgrade laboratory capacity, and ensure real-time surveillance and contact tracing in high-burden pockets.
• Combat MDR-TB with Modern Treatment: Scaling up newer and shorter MDR-TB drug regimens, while ensuring universal drug-susceptibility testing, is critical to prevent resistance spread.
• Address Social Determinants: Holistic interventions focused on nutrition, sanitation, housing, and poverty reduction must supplement biomedical efforts.
• Secure Sustainable Financing: Government and development partners should bridge the financing deficit and accelerate funding for research-driven innovations including vaccines.

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About World TB report

• Overview: It is a Flagship assessment of global tuberculosis burden, trends, and responses.
• Published by: World Health Organization (WHO).
• Frequency: Annual report published every year.
• Aim: 
• • To present updated global, regional, and national TB statistics.
  • To monitor progress toward End TB goals and identify gaps in surveillance and health systems.

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