The need for universal and equitable health coverage

India has made substantial and tangible progress in Tuberculosis (TB) care, adopting new strategies to detect, treat and prevent TB.

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Some key areas of progress include the expansion of molecular testing for rapid detection of TB and drug-resistance; the introduction of the shorter, all-oral BPaLM regimen (a combination of four drugs Bedaquiline (B), Pretomanid (Pa), Linezolid (L), and Moxifloxacin (M)); doubling of the entitlement under the Ni-kshay Poshan Yojana (NPY) for nutrition support to 21,000 a month; roll-out of TB preventive therapy; and an expanded role for communities through the involvement of TB survivors and Champions. The impact of the roll-out of these strategies can be seen in the 17.7% decline in TB incidence in India, from 237 per 1,00,000 population in 2015 to 195 per 1,00,000 population in 2023, in tandem with a 21.4% reduction in TB-related deaths.

Since Independence, India’s public health system has delivered disease control services through primarily vertical health programmes, such as the National Tuberculosis Elimination Programme (NTEP). While this vertical nature has allowed for concentrated focus and brought benefits in many ways, it has also been limiting. Integration of TB services within the broader public health system is key to India’s pursuit of equitable, universal health coverage (UHC) for all.Decentralising TB care for all