Context: According to the latest World Health Organization’s (WHO) Global Tuberculosis Report, while the estimated number of tuberculosis (TB) cases in India decreased slightly in 2023, the number of cases reported increased – a positive sign that the gaps in diagnosis are closing.

• The  report shows that although India has made some progress, it continues to have the highest disease burden.

About Tuberculosis

• Tuberculosis is an infectious disease caused by bacteria (Mycobacterium tuberculosis) and most commonly affects lungs and is curable as well as preventable

• It spreads through the air when people with lung TB cough, sneeze or spit.

Key Findings of the Report

• In 2023, TB likely became the leading infectious killer globally, surpassing Covid-19.

• TB Treatment coverage: It  has increased to 75% as against target of 90% by 2027

India specific findings

• India accounted for 26% of the global TB burden in 2023 and  26% of global TB related deaths.

• India ranks 1st globally in burden of multidrug resistant/Rifampicin-resistant TB

Issues highlighted by Report

• Inadequate funding  in low- and middle-income countries: It was merely US$ 5.7 billion(in 2023) equivalent to only 26% of the global target of reaching US$ 22 billion per year(2027).

• Funding in TB Research: It was US $1 billion(2022) as against target of US$5 billion(2027)

• Catastrophic health costs (>20% of annual household income):  Around 50%  of the TB-affected households globally face catastrophic costs, far above the WHO End TB Strategy target of zero.

• The data show that 30 mostly low- and middle-income countries (LMICs) bear 87% of the global TB burden, with five countries—India (26%), Indonesia (10%),China (6.8%), the Philippines (6.8%), and Pakistan (6.3%)—combining for 56% of the burden. 

• 55 percent of people who developed TB were men, 33 percent were women, and 12 percent were children and young adolescents.

• According to the report, a significant number of new TB cases are driven by five major risk factors: undernutrition, HIV infection, alcohol use disorders, smoking, and diabetes.

• In 2023, India was estimated to have had 27 lakh TB cases, of which 25.1 lakh persons were diagnosed and put on treatment. 

• This has buoyed India's treatment coverage to 89 percent in 2023 from 72 percent in 2015, thereby bridging the gap of missing cases.

• It acknowledged a drop in India's TB incidence - from 237 per lakh populationin 2015, to 195 per lakh population in 2023, accounting for a 17.7 percent decline.

India’s Initiatives for TB Prevention

• Pradhan Mantri TB Mukt Bharat Abhiyan 

• Universal Drug Susceptibility Testing (UDST): To rule out drug resistance before or at the time of treatment initiation itself.

• Addition of newer drugs: E.g. Bedaquiline and Delamanid for management of drug resistant TB