India's decline in TB mortality has outpaced the global average. Examine the role of active case finding and technology in this outcome, and identify the remaining gaps in achieving the End TB targets.

The WHO Global TB Report 2026 estimates that India's TB deaths have fallen 38% since 2015, against a 35% global decline. India's TB death rate dropped from 28 to 18 per lakh [1]. Finding patients early and treating them reliably drove much of this gain. But India is still well short of the End TB targets.

Role of Active Case Finding

• 100-day TB Mukt Bharat Abhiyaan (first round December 2024, second March 2026): it screened over 25 crore people and found 48.64 lakh new cases [1].
• Detecting cases without symptoms: 14.97 lakh of those cases, nearly a third, had no symptoms. A passive system that waits for patients with symptoms would have missed them [1].
• Treatment coverage rose from 53% (2015) to 92% (2024), so far fewer patients now go uncounted [2].
• Jan Bhagidari: JOSH Teams, PRIs and Ni-kshay Mitras take screening and nutrition support to the last mile [1].

Role of Technology

• AI-enabled chest X-rays + NAAT (a molecular test) give fast and accurate diagnosis in the field [1].
• AI risk-flagging identifies patients likely to do poorly, so their care can be adjusted to their risk (differentiated care) [1].
• Ni-kshay portal tracks patients and their treatment in real time [1].
• Outcome: 94% treatment success in drug-susceptible TB [1].

Screen (AI X-ray) → Confirm (NAAT) → Treat + Nutrition → Track (Ni-kshay) → Fewer deaths

Fig: The find–treat–track chain behind falling mortality

Remaining Gaps vs End TB Targets

• New cases are falling more slowly than deaths: incidence fell only about 21% (237 → 187 per lakh, 2015–24) [2]. The 2030 target is an 80% fall [3], which shows TB is still spreading.
• Deaths: India has achieved a 38% fall; the 2030 target is 90% [1][3].
• Catastrophic costs: the target is that no TB-affected family faces catastrophic costs [3]. Yet the headline reporting gives no figure for this [1].
• Limits of the 94% figure: it excludes drug-resistant TB and the roughly 8% of estimated patients who are not on treatment [1][2].
• Campaign mode: TB keeps spreading between the 100-day screening drives. The programme is 96% domestically funded [1], so year-round screening will need dedicated budgets.

Active case finding and modern diagnostics have changed TB care from waiting for patients to seeking them out, and India has cut deaths faster than the world. The next phase should make AI screening a year-round service and report incidence and catastrophic costs alongside deaths. It should also sustain domestic financing. That move from control to elimination is what SDG 3.3 and the End TB Strategy require [3].