Can India Eliminate TB by 2025?

India has set an ambitious goal to eliminate tuberculosis (TB) by 2025, five years ahead of the World Health Organization’s (WHO) target. However, the country is struggling to meet this goal due to a lack of funding, irregular availability of essential medicines, and inadequate healthcare infrastructure. The data and insights in this article are inspired by a report from IndiaSpend.

Funding Shortfalls

The Indian government created a plan called the National Strategic Plan (NSP) to fight TB. However, between 2017 and 2020, only about two-thirds of the required budget was allocated. While spending on TB care has increased significantly since 2014, the total amount of money provided (Rs 83.13 billion) was still far less than the required Rs 123.27 billion.

This shortage of funds has slowed down progress in reducing TB cases. In 2016, India had 211 TB cases per 100,000 people, and by 2022, this dropped only slightly to 199 per 100,000. To achieve the elimination target, this number needs to come down to 44 cases per 100,000 by 2025. Similarly, TB deaths, which were at 32 per 100,000 in 2016, need to be reduced to just 3 per 100,000. However, as of 2022, the number still stood at 23 deaths per 100,000 people.

Medicine Shortages and the Importance of Early Detection

TB treatment needs to be continuous. If a patient stops taking medicine due to a shortage, the TB bacteria can become drug-resistant, making it harder to treat. Unfortunately, there have been frequent shortages of TB medicines across the country, even in 2024. In many states like Chhattisgarh, Rajasthan, Jharkhand, Madhya Pradesh, Maharashtra, and Karnataka, doctors have reported a "crisis" in the availability of TB drugs.

Government reports also show that in Bihar, every district that was audited had a shortage of at least one TB drug between 2016-17 and 2020-21. To manage these shortages, health centers sometimes used medicines meant for children or reduced the number of doses given to patients.

Experts say that the problem is not just a lack of money but also delays in the government’s process of buying medicines. Some suggest that India should centralize its medicine procurement system to make drug distribution faster and more efficient.

Outdated Diagnostic Methods

Early detection of TB is crucial, and India planned to shift from outdated smear microscopy tests to modern nucleic acid amplification tests (NAAT), which provide more accurate results. However, in 2024, only 26.2% of all TB tests were done using NAAT, while most were still using the 140-year-old microscopy method.

Microscopy tests can give quick results but are not as effective in detecting TB in children or drug-resistant cases. Experts recommend increasing the use of advanced testing techniques like TruNAAT, which is an Indian-made technology.

Shortage of Healthcare Workers and Infrastructure Problems

Even when funds are available, many states lack enough trained staff to implement TB programs effectively.

• In Andhra Pradesh, a shortage of health workers slowed down TB treatment efforts.

• Bihar had several vacant positions for TB program coordinators and supervisors.

• Maharashtra had a high vacancy rate for TB doctors.

• Uttarakhand used only 59% of its allocated TB funds due to poor healthcare infrastructure.

• Odisha faced a shortage of doctors and lab assistants needed for TB testing.

  
  

Without enough healthcare workers, even well-funded programs cannot function properly.

Financial Burden on TB Patients

TB treatment can be costly, and many families struggle to afford it. The government provides Rs 1,000 per month to TB patients under the Nikshay Poshan Yojana (NPY) to help them with nutrition and other expenses. However, many eligible patients do not receive this benefit. For example, in Chhattisgarh, 17.23% of TB patients reported that they did not receive this financial aid.

With only nine months left until the 2025 deadline, India still has a long way to go in its fight against TB. The major challenges include:

• Insufficient funding

• Shortage of medicines

• Outdated testing methods

• Lack of healthcare workers

• Financial difficulties for TB patients

  
  

To overcome these obstacles, India needs to increase investment in TB programs, ensure a steady supply of medicines, improve testing facilities, and recruit more healthcare professionals. If these steps are not taken urgently, the goal of eliminating TB by 2025 may remain out of reach.