India closing the gap between estimated and reported TB cases: Report

India TB Report 2024, by the Ministry of Health and Family Welfare, highlights the pressing need to improve the adoption of latest technology to combat the disease.

Indian Ministry of Health and Family Welfare’s annual report on the state of tuberculosis (TB) India TB Report 2024 shows significant progress in the detection and treatment of the disease over the last decade. However, does this mean that the target for complete eradication of TB by 2025 is achievable?

The recently released report highlights that there has been a 16 per cent reduction in overall TB incidence from 2015 till 2022. India is currently able to initiate treatment for 95 per cent of all diagnosed patients, meeting its target for 2023.

Furthermore, India has been able to overcome one of the biggest hurdles in TB elimination, namely under-reporting of cases. The reported number of TB cases has been inching close to the estimated number of cases. There were 25.5 lakh reported cases in 2023 against an estimated 27.8 lakh cases. The difference of 2.3 lakhs is an improvement from previous year’s difference of 3.2 lakh.

Given that TB has many strains, and the multi-drug resistant (MDR) version of the disease has spread and grown in number, India needs to improve the adoption of latest technology to combat the disease, says the report. The current prevalent method for diagnosis is through microscopy, which fails in accurately detecting all MDR cases. This leaves a lot of cases undetected or improperly diagnosed.

MDR patients may require a second-line of drugs, as the first-line drugs may prove ineffective. The report shows an improvement of 25 per cent from 2015 to 60 per cent in 2022 of patients being offered a diagnostic test to check whether the TB infection is drug resistant and needs second-line drugs.

India TB Report 2024 also sheds light on the fact that the drugs available for the MDR strain of TB are quite demanding on the patients, both in terms of duration and cost. Data shows that the most affected hail from the backward classes, and have pre-disposed conditions, such as HIV/AIDS. The other major risk factors are undernourishment, diabetes, smoking and consumption of liquor.

Currently, a shorter duration drug, Bedaquiline, is on the market and can be a viable choice for a large number of TB patients. Until last year, Johnson and Johnson held the patent for the drug, which has not been renewed by India’s patent office, opening the door for the domestic industry to come in and introduce cheaper generic versions to the market.

Another encouraging factor is the focus on the mental health toll of the disease. Doctors and physicians are being sensitised and trained to address the mental health of TB patients. Although India is on the right path in its fight against TB, the country has a long way to go in completely eliminating the disease.