India Speeding Towards TB Elimination

1. At a Glance

• Tuberculosis (TB): bacterial infection (Mycobacterium tuberculosis) primarily attacking lungs; India bears the highest global TB burden (~25% of cases) [3].
• India targets TB elimination by 2025, five years ahead of the UN SDG 3.3 (2030) target [2].
• Implemented via National TB Elimination Programme (NTEP) under MoHFW; flagship vehicle is Pradhan Mantri TB Mukt Bharat Abhiyaan (PMTBMBA) [1][2].

2. Why in the News

• PIB Backgrounder (24 March 2026) released on World TB Day highlighted that new TB cases fell 21% (2015–2024) and TB mortality fell 28% in the same window [1][4].
• 100-Day Intensified TB Mukt Bharat Campaign (launched 7 December 2024, Panchkula) screened >20 crore vulnerable persons and diagnosed >28 lakh TB patients [1][4].
• 46,118 Gram Panchayats awarded TB-Free certification for 2024 [1].

3. Background & Evolution

• 1962: National Tuberculosis Programme (NTP) launched.
• 1997: Revised National TB Control Programme (RNTCP) with DOTS strategy.
• 2017: National Strategic Plan (NSP) 2017–25 set 2025 elimination target [2].
• 2020: RNTCP renamed National TB Elimination Programme (NTEP).
• 9 Sept 2022: PM TB Mukt Bharat Abhiyaan launched by President Droupadi Murmu; introduced Ni-kshay Mitra (community donor) initiative [S5 search list].
• 7 Dec 2024: 100-Day Intensified Campaign rolled out across 347 high-burden districts [1][4].

4. Core Static Facts

• Pathogen: Mycobacterium tuberculosis (Robert Koch, 1882).
• Nodal Ministry: Ministry of Health and Family Welfare; Central TB Division is the implementing arm [2].
• Digital backbone: Ni-kshay portal (web-based case management); developed by Central TB Division + NIC + WHO India [2].
• Patient support: Ni-kshay Poshan Yojana — DBT ₹1,000/month (revised from ₹500 in 2024) to every notified TB patient.
• BPaLM regimen (drug-resistant TB, approved 2024): Bedaquiline + Pretomanid + Linezolid + Moxifloxacin; 6-month course replacing 18–24 month regimens [1].
• WHO End TB Strategy targets (baseline 2015): 80% incidence drop & 90% mortality drop by 2030.
• TB incidence: 237→187 per lakh (2015→2024); mortality 28→21 per lakh [4].
• India share of global TB: ~25% (highest worldwide); followed by Indonesia 10%, Philippines 6.8%, China 6.5%, Pakistan 6.3% [3].

5. Multi-Dimensional Analysis

Social / Health Equity

• TB disproportionately afflicts urban poor, migrants, tribal populations, undernourished; Ni-kshay Mitra mobilises citizens, NGOs, corporates to adopt patients [1].
• Catastrophic costs: ~50% TB-affected households worldwide face costs >20% of income — WHO End TB benchmark is zero [3].

Scientific / Technological

• AI-driven screening: cough-sound AI, radiology AI for chest X-ray triage, predictive analytics for high-risk flagging [1].
• Molecular diagnostics: CB-NAAT/TrueNat scaled up; shorter BPaLM uses Pretomanid (TB Alliance) — first novel anti-TB combination in decades [1].

Administrative / Federal

• Centrally Sponsored Scheme with state implementation; Gram Panchayat-level TB-Free certification decentralises accountability — 46,118 GPs certified (2024) [1].
• 100-day campaign integrates ASHA/ANM, AB-HWCs, and PM-JAY linkages.

Economic

• TB causes ~US$32 bn annual productivity loss to India (WHO estimates); global funding gap of US$22 bn/year by 2027 highlights resource crunch [3].

Geopolitical / Multilateral

• India aligned with WHO End TB Strategy (2014) & UN High-Level Meeting on TB (2023) declaration; voluntary advancement of SDG 3.3 to 2025 sets a diplomatic benchmark [3].

6. Recent Developments (12–18 months)

• Aug 2024: MoHFW approves BPaLM regimen under NTEP [2].
• 7 Dec 2024: 100-Day TB Mukt Bharat Abhiyaan launched by Health Minister J.P. Nadda at Panchkula, Haryana [4].
• 2024: Ni-kshay Poshan Yojana DBT raised to ₹1,000/month.
• 2024: 46,118 Gram Panchayats certified TB-Free [1].
• 24 March 2026 (World TB Day): PIB backgrounder reports 21% incidence and 28% mortality decline (2015–24) [1][4].

7. Prelims Hooks

• World TB Day: 24 March (anniversary of Koch's 1882 discovery) [1].
• Causative organism: Mycobacterium tuberculosis — bacterium, not virus.
• NTEP nodal body: Central TB Division, MoHFW [2].
• BPaLM = Bedaquiline + Pretomanid + Linezolid + Moxifloxacin (for MDR-TB) [1].
• India's TB elimination target: 2025 (vs SDG 2030) [2].
• PM TB Mukt Bharat Abhiyaan launched by President Droupadi Murmu, 9 Sept 2022.
• Ni-kshay portal partner agencies: NIC + WHO India [2].
• Ni-kshay Poshan Yojana: DBT nutritional support, now ₹1,000/month.
• 100-Day Campaign launch date: 7 December 2024 at Panchkula, Haryana [4].
• TB incidence dropped from 237 → 187 per lakh (2015–24); mortality 28 → 21 per lakh [4].
• India accounts for ~25% of global TB cases (rank 1) [3].
• Gram Panchayats certified TB-Free in 2024: 46,118 [1].
• Vulnerable persons screened under campaign: >20 crore; patients diagnosed >28 lakh [1].

8. Mains Relevance

• GS-II — Issues relating to development & management of Social Sector/Health.
• GS-III — Science & Technology (AI in healthcare, new drug regimens).
• Possible question stems: 1. "Despite outpacing global decline rates, India's 2025 TB elimination target remains aspirational. Discuss the structural bottlenecks and recent course-corrections under NTEP." (GS-II, 15 marks) 2. "Examine the role of AI-driven diagnostics and community-based interventions like Ni-kshay Mitra in accelerating TB elimination in India." (GS-III, 10 marks) 3. "Compare WHO End TB Strategy targets with India's national commitments. What lessons does India's 100-Day Abhiyaan offer for high-burden countries?" (GS-II, 15 marks)

9. Related Topics to Study Next

• SDG 3 (Good Health & Well-being) — TB elimination is target 3.3.
• Ayushman Bharat (PM-JAY, HWCs) — diagnostic & treatment integration platform.
• PM Poshan / Anaemia Mukt Bharat — nutrition-TB linkage.
• WHO End TB Strategy & Stop TB Partnership — global framework.
• Universal Immunization Programme (BCG vaccine) — primary prevention.
• Antimicrobial Resistance (AMR) — MDR/XDR-TB context.
• Digital Public Infrastructure in health (ABHA, eSanjeevani, Ni-kshay) — governance tech.
• One Health approach — zoonotic M. bovis TB.

10. Common Errors / Trap Areas

• RNTCP was renamed NTEP in 2020 — RNTCP no longer exists.
• India's elimination target is 2025, not 2030 (SDG global target).
• BPaLM contains Moxifloxacin (the "M"); the WHO BPaL regimen (without M) is a separate variant — do not confuse.
• Ni-kshay Mitra (donor scheme) ≠ Ni-kshay Poshan Yojana (DBT to patient) ≠ Ni-kshay portal (IT system).
• TB elimination is defined as <1 case per million population, not zero cases.
• Pradhan Mantri TB Mukt Bharat Abhiyaan was launched by the President, not the PM, despite its name.