In December, the Maharashtra government introduced the 100-day campaign under the National Tuberculosis Elimination Programme (NTEP) to combat TB. Now it has intensified its efforts. THE WEEK spoke to Dr Swapnil M. Khadake, HOD & Consultant Critical Care, Fortis Hiranandani Hospital, Vashi on India's efforts at elimination of TB so far and the roadmap ahead.
Q: How far have we come in our efforts at elimination of Tuberculosis?
A: India has made great progress under the National Tuberculosis Elimination Program (NTEP), which aims to eliminate TB by 2025—five years ahead of the global target.
The availability of tests like CB-NAAT and TrueNat has improved early detection as well. An increase in treatment access through government programs that provide free TB drugs has also helped. Additionally, programs like Nikshay Poshan Yojana that offer financial aid to TB patients and address malnutrition, which are key risk factor in patients, also played a significant role.
Door-to-door screening has helped identify undiagnosed cases, especially in high-risk populations. Despite these efforts, TB remains a major public health challenge.
Q: What are the main challenges?
A: While India has made progressive strides, several concerns continue to hamper progress:
• Many cases remain undiagnosed
• Drug-resistant TB (MDR-TB, XDR-TB) that requires longer, and costlier treatments
• Many patients seek care late, allowing the disease to spread
• Discrimination-related treatment delay and non-compliance
• Existing conditions like HIV, diabetes, and malnutrition increase TB risk and worsen outcomes
Q: What lessons on TB management can we learn from our counterparts in other countries?
A: We can take insights from successful models in other countries as listed below:
• China: Integrated TB care with general health services and ensure universal access to rapid diagnostics.
• Japan: Focused on latent TB treatment, preventing new infections from progressing to active disease.
• South Africa: Integrated HIV-TB co-management, improving survival in immunocompromised patients.
• USA & Western Europe: Implemented strict infection control in healthcare settings and high-risk populations.
Q: What are the preventive aspects of TB?
A: Prevention remains our most cost-effective tool in fighting TB. We must emphasise:
• Early diagnosis and complete treatment – Prevents further spread.
• BCG vaccination – The Bacillus Calmette–Guérin (BCG) vaccine is used against TB though primarily effective in children, ongoing research suggests potential benefits in adults.
• Preventive therapy (IPT) – Treating latent TB in high-risk groups can reduce new infections.
• Programs like Nikshay Poshan Yojana help build immunity.
• Proper ventilation, cough hygiene, and masks reduce airborne transmission.
• Controlling diabetes, smoking, alcohol abuse, and indoor air pollution lowers TB vulnerability.
Q: How long will it take for India to eliminate TB and what are the top three ways of doing it?
A: The 2025 elimination goal is ambitious, and while India has made progress, full eradication may take longer. However, with focused efforts, we can significantly reduce the TB burden by 2035. TB elimination is not just a medical challenge but a social and economic one.
Three critical steps to accelerate elimination:
• Ensuring TB cases treated outside government facilities are reported and managed as per guidelines.
• Identifying and treating latent TB, especially in close household contacts, diabetics, and immunocompromised individuals.
• Shorter, more effective drug regimens, AI-led diagnostics, and next-generation vaccines like M72/AS01E can revolutionise TB control.
