India's Remarkable Decline in TB Cases Reflects Strong Political Commitment: Ex-WHO Director

New Delhi: India’s significant decline in tuberculosis (TB) cases and deaths is a testament to its political resolve and healthcare initiatives, said Mario C. B. Raviglione, former Director of the Global Tuberculosis Programme at the World Health Organization (WHO). Speaking to IANS, Raviglione, now a Professor of Global Health at the University of Milan, described the progress as "remarkable" and highlighted the critical role of strong leadership in combating the disease.

“There has been major progress in India over the last 25 years. The 18% decline in TB cases over the past decade, averaging around 2% per year, is remarkable for a country that contributes significantly to the global TB epidemic,” said Raviglione. India, with an estimated 2.8 million TB cases annually, has made noteworthy strides in reducing both the incidence and mortality rates of the disease.

Government data shows that TB incidence has decreased by 17.7%, from 237 cases per 100,000 population in 2015 to 195 per 100,000 in 2023. Similarly, deaths caused by TB dropped by 21.4%, from 28 per lakh population in 2015 to 22 per lakh in 2023. “Achieving this decline in a country as large as India is a clear indication of effective interventions,” he added.

Raviglione praised the high level of political commitment displayed in India, particularly under the leadership of Prime Minister Narendra Modi. “It is almost unique to see a head of state so vocally committed to tackling a disease. This commitment must be maintained to sustain progress in fighting TB,” he noted.

However, despite these achievements, India faces significant challenges in its bid to eliminate TB by 2025—five years ahead of the global target of 2030. Raviglione emphasized the need for accelerated efforts, particularly in the areas of rapid molecular testing and early diagnosis.

“Rapid molecular testing should be available at every point of care. Expanding its use can not only speed up TB diagnosis but also improve the detection of drug-resistant TB, allowing for better treatment choices,” he explained. Additionally, he called for large-scale population screening campaigns to identify cases early and provide preventive measures for individuals exposed to TB.

The professor also stressed the importance of addressing social determinants of TB, such as undernutrition, smoking, alcoholism, poverty, and air pollution. A multi-sectoral approach involving various stakeholders is essential for long-term success.

Another pressing issue is the financial burden faced by TB patients. Despite free treatment availability in India, many patients incur significant costs during the diagnostic process. “People often visit multiple doctors, from modern to traditional medicine, and undergo several tests before receiving a correct diagnosis. For those living in poverty, these expenses can be catastrophic,” said Raviglione.

The former WHO official urged policymakers to address these economic challenges and ensure accessible healthcare for all. “Reducing the financial strain on TB patients is critical for achieving sustainable progress,” he concluded.

India’s efforts to combat TB have yielded promising results, but Raviglione’s insights underscore the need for continued innovation and resource allocation to achieve the ambitious goal of eliminating the disease.