WHO Global Tuberculosis (TB) Report 2025

• 17 Nov 2025

For Prelims: World Health Organisation, Tuberculosis (TB), Human Immunodeficiency Virus,  Pradhan Mantri TB Mukt Bharat Abhiyan, Ni-kshay Mitras

For Mains: India’s progress and challenges under the National TB Elimination Programme (NTEP) , Drug-resistant TB

Source: TH

Why in News?

The World Health Organisation (WHO) Global Tuberculosis (TB) Report 2025 shows a sharp 21% fall in India’s TB incidence, dropping from 237 per lakh in 2015 to 187 per lakh in 2024 nearly twice the pace of the global decline and marking a major milestone in India’s fight against the disease.

What are the Key Findings of the WHO Global TB Report 2025?

• Global: In 2024, 10.7 million people fell ill with TB and 1.23 million died. The incidence rate was 131 per 100,000 and the case fatality rate was 11.5%.
  • TB is among the top 10 causes of death globally and the leading killer from a single infectious agent.
  • High-burden Countries: 30 high-burden countries account for 87% of global TB. The top contributors are India (25%), Indonesia (10%), Philippines (6.8%), China (6.5%), Pakistan (6.3%), Nigeria (4.8%), DR Congo (3.9%), Bangladesh (3.6%).
  • Key Drivers of TB Incidence: Undernutrition, low income, Human Immunodeficiency Virus (HIV), diabetes, smoking, and alcohol-use disorders.
• India’s Achievement in Sharp Decline: India accounts for 25% of global TB cases but has shown one of the fastest declines among high-burden countries. Treatment coverage improved from 53% (2015) to 92% (2024).
  • India’s TB mortality rate fell from 28 per lakh in 2015 to 21 per lakh in 2024. However, despite this progress, India still accounted for about 28% of all TB deaths worldwide in 2024.
  • Treatment success rate under Pradhan Mantri TB Mukt Bharat Abhiyan is at 90% (2024), above the global average of 88%.
  • India reports one lakh cases remained “missing,” meaning undiagnosed cases that continue to spread the infection. India still contributes 8.8% of the global detection gap, second only to Indonesia (10%).

What are the Factors Contributing to the Decline in India’s TB Incidence?

• Early Detection at Scale: Early diagnosis has improved sharply with the rapid expansion of molecular testing facilities. 
  • India now has the world’s largest TB lab network, and 92% of patients receive upfront Rifampicin drug-resistance testing. This level of early detection helps cut transmission at the source.
  • India diagnosed its highest-ever 26.18 lakh TB cases in 2024, closing much of the gap between estimated and detected cases.
• Use of New Technologies: Artificial Intelligence (AI) -enabled handheld X-ray devices, portable diagnostic tools, and expanded NAAT (Nucleic Acid Amplification Testing) coverage have made it easier to find TB quickly, even in remote and high-burden areas. 
• These technologies allow faster screening and reduce delays in starting treatment.
• New and Shorter Treatment Regimens: Introduction of the BPaLM (bedaquiline, pretomanid, linezolid, moxifloxacin) regimen reduced DR-TB treatment duration from 18–24 months to just 6 months. 
  • All-oral MDR-TB therapies improved safety, reduced dropouts and increased successful treatment outcomes.
• Large-Scale Community Screening: Community screening under the TB Mukt Bharat Abhiyan has reached unprecedented levels. 
  • More than 19 crore vulnerable people were screened, leading to the detection of 24.5 lakh patients, including 8.61 lakh asymptomatic cases. Identifying silent carriers is a major reason for reduced transmission.
  • Care has moved closer to communities through 1.78 lakh Ayushman Arogya Mandirs and Ni-kshay Mitras, 
    • This decentralisation helps people access testing and treatment quickly, preventing long delays that allow TB to spread.
• Improved Nutrition and Social Support: Under the Ni-Kshay Poshan Yojana (NPY), financial support for TB patients' nutrition has been increased from Rs 500 to Rs 1,000 per month, providing Rs 3,000 to Rs 6,000 per patient throughout treatment. 

What is India’s TB Elimination Target?

• In 2020, India renamed the Revised National Tuberculosis Control Programme (RNTCP) as the National TB Elimination Programme (NTEP) to align with its goal of eliminating TB by 2025, five years ahead of the global target of 2030.
  • Elimination of TB as a public health problem is defined as less than one notified TB case (all forms) per million population and year.
• The NTEP follows the National Strategic Plan (2017-2025), focusing on four key actions: Detect – Treat – Prevent – Build (DTPB) to control and eliminate TB in India.
• While the WHO’s End TB Strategy seeks an 80% reduction in incidence and a 90% reduction in deaths by 2030 (compared to 2015 levels). 
• India has achieved only a 21% decline in new cases and a 28% decline in deaths between 2015 and 2024.

Why is India Struggling to Meet its 2025 TB Elimination Target?

• High TB Burden and Rapid Transmission: India carries the world’s highest TB burden, making elimination difficult. 
  • Overcrowded slums, poor ventilation and dense living conditions allow the infection to spread quickly, keeping transmission levels high despite improvements in detection.
• Drug-Resistant TB (MDR/XDR): Many patients do not complete the full course of treatment, and antibiotics are often misused. This leads to multi-drug resistant (MDR) and extensively drug-resistant (XDR) TB, which are much harder and more expensive to treat.
• Delayed or Missed Diagnosis: A large section of the population, especially in rural, tribal, and hard-to-reach areas, does not have access to rapid TB tests. 
  • Delayed diagnosis means the disease continues to spread silently in the community.
• Co-existing Diseases and Risk Factors: High prevalence of diabetes, HIV, undernutrition and smoking weakens immunity and increases the risk of infection.
  • Rising air pollution further harms lung health. In 2024 alone, around 3.2 lakh TB cases were linked to diabetes.
• Challenges in the Private Sector:  Nearly half of TB patients first visit private doctors. However, many private clinics use outdated tests, inconsistent drug regimens, and do not report cases to the government.  This leads to missed cases and poor quality of treatment.
• Undernutrition and Poor Living Conditions: Malnutrition remains one of the biggest risk factors for TB in India. 
  • Poor-quality diets and food insecurity weaken immunity, making people more vulnerable to infection and slower to recover.
• Health System Gaps: Some areas face shortages of trained health workers, irregular drug supply, and weak follow-up mechanisms. 
  • These gaps reduce treatment adherence and increase the risk of drug resistance.
  • TB in children often shows subtle symptoms and requires specialised tests. As a result, many cases remain undetected or are diagnosed late.

What Measures can Strengthen TB Elimination Efforts in India?

• Expand Early and Accurate Diagnosis: Scale up rapid molecular tests such as CBNAAT and TrueNat at district and sub-district levels to ensure uniform access.
  • Early detection cuts transmission chains, identifies drug resistance sooner and reduces the number of “missing” cases.
• Tackle Drug-Resistant TB With Stronger Interventions: Scale up shorter, patient-friendly regimens like BPaL, which reduce MDR treatment duration from 18–24 months to 6 months.
  • Faster and more tolerable treatments improve outcomes and control the spread of difficult-to-treat TB strains.
• Address Major Risk Factors and Co-Morbidities: Integrate TB screening with diabetes, HIV, malnutrition, alcohol-cessation and tobacco-control programmes. Improve air-quality management, especially in high-burden cities.
• Strengthen Preventive Therapy (TPT): Improve awareness about preventive treatment targeting children, HIV-positive individuals and high-risk groups.
  • Preventive therapy stops latent infections from progressing into active TB, crucial for long-term incidence reduction.
• Restore and Strengthen Post-Covid Health Infrastructure: Covid-19 diverted manpower, labs and resources, slowing progress in several states. Rebuild TB laboratory systems and restore manpower that was diverted during the pandemic.
• Strengthened Public-Private Collaboration: Encouraging public–private collaboration can strengthen R&D for new vaccines, point-of-care diagnostics and shorter drug regimens. 
  • This can lead to adoption of standardised treatment guidelines across private providers and help reduce misdiagnosis and incomplete treatment.

Conclusion

India has made strong progress in reducing TB incidence and improving treatment outcomes, but elimination by 2025 remains out of reach. Sustained innovation, stronger health systems and targeted community support are essential to accelerate India’s path toward TB elimination.

Drishti Mains Question:

Q. Discuss how decentralised TB services and new diagnostic technologies have transformed India’s TB response.

Frequently Asked Questions (FAQs)

1. What decline in TB incidence has India achieved according to the WHO Global TB Report 2025?

India recorded a 21% decline in TB incidence between 2015 and 2024, dropping from 237 to 187 per lakh population.

2. What is India’s treatment coverage under NTEP in 2024?

Treatment coverage reached 92% in 2024, up from 53% in 2015.

3. What percentage of global TB cases does India account for?

India accounts for 25% of global TB cases, the highest among all countries.

4. What is BPaLM regimen (bedaquiline, pretomanid, linezolid, moxifloxacin)?

The BPaLM regimen is a new, shorter, all-oral treatment for drug-resistant tuberculosis (DR-TB), it cuts treatment duration from 18–24 months to just 6 months.

UPSC Civil Services Examination, Previous Year Questions (PYQs)

Mains

Q. Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse. (2021)