Tuberculosis continues to be among the most potent infectious diseases that kill. Little wonder then that the World Health Organization has been monitoring the global TB burden since 1995. This year’s Global Tuberculosis Report shows that it infected more than eight million people in 2023, out of which 1.25 million succumbed to it. India, which accounts for more than a quarter of the global TB burden, has taken encouraging steps to check the contagion. In 2017, the Union ministry of health unveiled the National Tuberculosis Elimination Programme, which aimed to eradicate the disease by 2025 by setting several milestones, including lowering the death rate from the then prevalent 32 per 1,00,000 to 6 per 1,00,000 in 2023. The health agency's latest report, which comes a year ahead of India's elimination target, has thrown up a mixed bag of findings for India. For instance, the country witnessed a decline in TB deaths, from 3.31 lakh in 2022 to 3.2 lakh in 2023. Moreover, India has been able to expand its treatment coverage to 85%. Effective diagnosis may be the reason behind the falling incidence rate — TB has declined by 18% in the past eight years. Experts suggest that the decentralisation of TB treatment — an increase in microscopy centres is one feature of this — has made a difference. The introduction of the BPaLM regimen — the new, highly effective, and shorter treatment regimen for Multidrug-Resistant Tuberculosis — has also been a welcome intervention. Political will must be combined with investments in cutting edge treatment and public awareness campaigns to succeed in this battle against the deadly disease.

But the WHO report has also revealed some glaring shortcomings. For instance, India's TB death rate was 22 per 1,00,000 population in 2023 — over three times higher than its intended target. Even though the incident rate has been declining, it was still twice the national target. Worryingly, government funding for TB elimination appears to be shrinking. The existence of MDR-TB is an additional concern. An estimated 1,19,000 new cases of this virulent strain of TB emerge in India annually but the country’s TB programme reports a little over half of this. Erroneous prescription and dosage, poor quality of drugs, and the discontinuation of medication regimens are some of India’s other challenges. Taken together, they raise doubts about India’s ability to eradicate TB in the window of time that remains.