Towards Ending TB - India's Strategic Response & Progress

Tuberculosis (TB) remains a significant public health challenge globally, and India bears the highest burden, accounting for a quarter of cases worldwide.

- Dr. Shruti Patel

Recognizing the diverse TB epidemiology across its states and the significant role of the private healthcare sector, India adopted a sub-national assessment approach. The National TB Programme has evolved significantly since the introduction of DOTS in 1997, embracing the Stop TB Strategy in 2006 and the End TB Strategy in 2015. A pivotal step was the integration of the TB program into the general health system under the National Health Mission (NHM), facilitating resource optimization and mainstreaming of human resources. The program was renamed the National TB Elimination Program (NTEP) in 2020, underscoring its ambitious goal.

Key Strategies and Innovations:

India’s response has been characterized by prioritizing innovations across various domains.

• Diagnostics: Scaling up rapid molecular testing infrastructure with over 8,295 machines, establishing an annual capacity of over 14 million tests. Introduction of digital chest X-ray as a screening tool and exploration of AI-based tools for automated reading. Development and validation of indigenous tools like TrueNAT and Cy-TB.

• Treatment: Introduction of shorter drug regimens and focus on improving outcomes for drug-resistant TB, with treatment success rates reaching 87% for MDR-TB. Expansion of drug susceptibility testing (DST) to all TB patients.

• Digital Health: Development and implementation of Nikshay, a real-time integrated digital surveillance system for patient management and drug logistics. Utilization of digital adherence tools like 99-DOTS and Video DOT, and a multilingual national call centre, Nikshay Sampark, for patient counselling.