Active case finding and asymptomatic TB detection mark a shift in public health strategy. Discuss their role, with reference to the TB Mukt Bharat Abhiyaan.

For a long time India's TB programme used passive case finding: only people who came to a clinic with symptoms were tested. Active case finding (ACF) turns this around. Health workers go out and screen high-risk groups, including people who feel healthy. The TB Mukt Bharat Abhiyaan has made ACF central to India's elimination strategy.

Nature of the shift

• Detect pillar: The National Strategic Plan to End TB 2020–25 calls for intensified case-finding under its Build–Prevent–Detect–Treat pillars [1].
• From clinic to community: The 100-Day Abhiyaan began on 7 Dec 2024 in 347 high-priority districts across 33 States/UTs. It used vulnerability mapping and systematic screening, and was later scaled up nationwide [1].

Role in the TB Mukt Bharat Abhiyaan

• Scale: Over 20 crore vulnerable people have been screened and over 28 lakh patients diagnosed [1].
• Finding hidden cases: The campaign found 9 lakh asymptomatic cases that "could have been missed otherwise" [1]. Overall, 14.97 lakh of 48.64 lakh detected cases (about 31%) had no symptoms [2].
• Breaking transmission: Earlier diagnosis shortens the time a patient can infect others. TB Preventive Treatment for household contacts and PLHIV is now part of case-finding drives [1].
• Technology: Over 500 AI-enabled hand-held X-rays and over 9,800 rapid molecular testing sites allow screening in the field [1].
• Jan Bhagidari: JOSH Teams of officials, NCC cadets and MY Bharat volunteers mobilise communities [2]. Over 30,000 elected representatives have taken part [1].
• Outcomes: India's TB mortality rate fell from 28 to 18 per lakh (2015–2025). That is a 38% fall, against 35% globally [2].

Limitations

• Weak follow-up: CAG (Report No. 3 of 2024, Delhi) found that District DR-TB Committees were not formed or were formed late, and that monitoring was weak [3]. When more cases are found but follow-up is weak, more patients risk dropping out of treatment.
• Certification incentives: 67,933 Panchayats were certified TB-free in 2025 [2]. If certification depends on reporting few cases, villages have no reason to look for more.
• Remaining burden: Incidence was still about 187 per lakh in 2024 [1], and the goal of ending TB by 2025 was not met [1].

ACF and asymptomatic detection have changed India's TB programme from waiting for patients to seeking them out. To make these gains last, follow-up teams must be fully staffed and TB-free certification must be tied to how many people were screened. Done together, this can help India meet SDG 3.3's 2030 goal and achieve a TB-Mukt Bharat.