Model Answer

Introduction

Tuberculosis continues to be India's most persistent public health challenge. The Global TB Report 2025 highlights that India recorded around 27.1 lakh TB cases and over 3 lakh deaths in 2024, the highest globally. Despite progress such as improved treatment coverage and new diagnostic technologies, India remains off-track to meet both its 2025 TB elimination goal and the WHO End TB Strategy milestones.

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1. Key Challenges Hindering TB Elimination

   • High disease burden and drug resistance: India accounts for nearly one-third of global drug-resistant TB cases. In 2024, 12.63% of previously treated and 3.64% of new cases were drug-resistant—making treatment longer, costlier, and less effective.
   • Gaps in achieving reduction targets: Between 2015–2024, India managed only a 21% reduction in new cases and 28% reduction in deaths, far below the 2025 milestones. This indicates slow progress despite intensified efforts.
   • Impact of Covid-19 and comorbidities: Disruptions due to the pandemic, coupled with widespread diabetes, under-nutrition, and high air pollution, have fueled new infections and worsened vulnerability.
   • Drug availability and nutritional support issues: Periodic shortages of common TB medicines, preparations for childhood TB, and delays in nutritional support transfer continue to constrain patient management.

2. Recent Innovations and Programmatic Advances

   • Expanded treatment coverage: India's treatment coverage improved from 85% (2023) to 92% (2024), primarily due to more active case finding, doorstep services, and better surveillance.
   • AI-enabled diagnostics: The use of AI-powered X-ray screening, mobile vans, and mass screening drives led to the detection of over 24.5 lakh TB cases, including 8.61 lakh asymptomatic cases—critical for breaking the transmission chain.
   • BPaL regimen for drug-resistant TB: The adoption of the BPaL regimen marks a major step forward. It reduces treatment duration for resistant TB from 18–24 months to just 6 months, improving adherence and reducing toxicity.
   • Innovative state models like TN-KET: Tamil Nadu's TN-KET differentiated care programme, which triages vulnerable TB patients and provides tailored care, has successfully reduced mortality and offers a replicable model for other states.

Conclusion/Way Forward

India has made notable progress through technological innovations, improved case detection, and shorter drug-resistant TB regimens. However, the scale of the challenge—ranging from drug resistance and comorbidities to health system gaps—continues to impede India's elimination goal. Achieving meaningful, sustained progress will require stronger public health infrastructure, uninterrupted drug supply, nutritional and social support, and consistent investment in early diagnosis and community-based care. With a focused and resilient approach, India can accelerate its journey toward ending TB in the coming decade.