India’s Struggle and Resolve: The Path to a Tuberculosis-Free Nation by 2025

On this World Tuberculosis (TB) Day, India finds itself at a defining moment in its battle against one of the deadliest infectious diseases. The country has set an ambitious goal of eliminating TB by 2025—five years ahead of the global target. This commitment is reflected in a series of policy interventions, diagnostic advancements, and community outreach programs. However, despite notable progress, TB continues to pose an immense challenge, particularly with the rise of drug-resistant strains and gaps in healthcare accessibility. As the deadline draws closer, India must navigate systemic hurdles and accelerate its efforts to make its vision a reality.

Tuberculosis remains one of India’s most pressing public health concerns, with the country accounting for nearly 25% of the global TB burden. While there has been a marked decline in incidence rates—from 237 per 100,000 people in 2015 to 195 per 100,000 in 2023—this progress is countered by the increasing prevalence of multidrug-resistant TB (MDR-TB). MDR-TB presents a significant challenge, as only 36% of estimated cases are diagnosed, and merely 34% of patients receive treatment. Even among those who start treatment, the success rate remains alarmingly low at 46%. These figures highlight the critical need for improved diagnostic capabilities, better treatment adherence, and enhanced patient support systems. TB thrives in conditions of poverty, overcrowding, and limited healthcare access, making its elimination a multidimensional challenge that requires interventions beyond the medical domain.

To combat this crisis, the Indian government has implemented a series of large-scale interventions under the National TB Elimination Program (NTEP), previously known as the Revised National Tuberculosis Control Programme (RNTCP). The program is guided by the National Strategic Plan 2017–2025, which operates on the pillars of prevention, detection, treatment, and community engagement. Among its recent initiatives, the 100-Day TB Elimination Campaign launched in December 2024 stands out as a focused effort to ramp up case detection, reduce diagnostic delays, and improve treatment outcomes, particularly in high-burden regions. The program’s emphasis on active case-finding, digital health solutions, and the engagement of private healthcare providers is a testament to the government’s evolving approach toward TB control. Yet, the biggest challenge remains ensuring that these policies translate into measurable impact at the grassroots level, where healthcare infrastructure disparities and social stigmas continue to impede progress.

The financial aspect of TB elimination is another crucial factor that determines the success of these interventions. Recognizing the gravity of the issue, the Indian government allocated approximately 31 billion Indian rupees for TB elimination efforts in the 2024 fiscal year. However, only 8 billion rupees were utilized, raising concerns about inefficiencies in fund deployment and bureaucratic hurdles that slow down the execution of critical programs. The underutilization of resources highlights the need for a more streamlined approach to funding distribution, ensuring that financial support reaches frontline healthcare workers, diagnostic centers, and treatment facilities without unnecessary delays. Without efficient financial planning, even the most ambitious TB elimination strategies risk falling short of their intended impact.

Despite these challenges, India’s fight against TB has seen several success stories, particularly in leveraging technology for better case detection and treatment monitoring. The use of AI-driven diagnostic tools, mobile-based adherence tracking applications, and community-led awareness programs has yielded promising results. Additionally, the involvement of private healthcare providers in TB management has played a vital role in expanding access to diagnostic and treatment services. However, these efforts must be scaled up significantly if India is to achieve its 2025 target. Ensuring mandatory accreditation of private laboratories, regulating TB treatment protocols in the private sector, and strengthening patient support systems are essential steps in this direction.

The urgency of TB elimination is further underscored by the alarming resurgence of the disease on a global scale. According to the World Health Organization’s 2024 report, TB cases reached 8.2 million in 2023—the highest since 1995—surpassing COVID-19 as the leading infectious disease killer. This global trend serves as a stark reminder that sustained vigilance and innovation are necessary to keep TB under control. While India has made progress, the looming threat of drug-resistant strains and underreported cases highlights the need for continuous advancements in diagnostics, vaccine development, and public health interventions.

As the 2025 deadline approaches, India stands at a crossroads where decisive action will determine the success or failure of its TB elimination mission. The government’s efforts, while commendable, must be reinforced by stronger execution mechanisms, greater community involvement, and increased global collaboration. The decline in TB incidence rates reflects the effectiveness of targeted interventions, yet the battle is far from over. The presence of drug-resistant strains, inefficiencies in healthcare delivery, and gaps in financial resource utilization demand immediate and sustained attention. The journey toward a TB-free India is a formidable one, requiring not just political will but a collective commitment from policymakers, healthcare professionals, researchers, and communities alike.

India’s ambitious vision for a TB-free nation is within reach, but only if the momentum is sustained, challenges are addressed with urgency, and every stakeholder plays an active role in turning this goal into a reality. The coming years will be crucial in determining whether India emerges as a global leader in TB elimination or struggles against the weight of its own challenges.