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After years of intensified focus on <keyword id="19897423" type="General" weightage="20" keywordseo="COVID-19" source="keywords">COVID-19</keyword>, <keyword id="19992404" type="General" weightage="100" keywordseo="Tuberculosis" source="keywords">tuberculosis</keyword> (TB) has once again emerged as the leading <keyword id="20564668" type="General" weightage="20" keywordseo="infectious-disease" source="keywords">infectious disease</keyword> killer worldwide. This resurgence is a sobering reminder that despite our pandemic response, TB has continued to claim lives, especially in low- and middle-income countries (LMICs), where resources are often stretched thin.<br /><br />According to the latest <keyword id="19896311" type="General" weightage="20" keywordseo="World-Health-Organization" source="keywords" meta.keywordsubtype="org" meta.entityname="World Health Organization" meta.hostid="261" meta.entityid="World Health Organization">World Health Organization</keyword> (<keyword id="19895006" type="General" weightage="20" keywordseo="WHO" source="keywords">WHO</keyword>) report, approximately 8.2 million people were diagnosed with TB in 2023, marking the highest number of cases recorded since global monitoring began in 1995.<br /><h2><keyword id="19895063" type="General" weightage="20" keywordseo="India" source="keywords">India</keyword> and Indonesia</h2>The recent spike in TB cases is largely driven by increases in two countries — India and Indonesia. Together, they accounted for 45% of the global rebound in TB diagnoses between 2021 and 2023, underscoring their critical role in the worldwide fight against TB. Three other countries, the Philippines, Nigeria, and Pakistan, also made significant contributions, collectively accounting for another 32% of the increase. This means that more than three-quarters of the global resurgence in TB can be traced to these five countries alone.<br /><br />One key reason for these increases is the “backlog” effect created by COVID-19 disruptions. During the pandemic, healthcare systems in many countries, including India and Indonesia, had to shift focus to COVID-19, which delayed TB diagnosis and treatment. In 2023, as these countries ramped up recovery efforts, many previously undetected TB cases surfaced, creating an apparent spike in reported numbers. This trend highlights the importance of sustainable healthcare infrastructure capable of handling simultaneous health crises.<br /><h2>Gaps in TB case detection</h2>Despite the daunting increase in TB cases, some countries have made notable progress in <keyword id="23741990" type="General" weightage="20" keywordseo="treatment-coverage" source="keywords">treatment coverage</keyword>. Among the 30 high-burden TB countries, those with the highest levels of treatment coverage in 2023 included Brazil, India, Mozambique, Papua New Guinea, Sierra Leone, Uganda, and Zambia, with coverage rates surpassing 80%. India’s <keyword id="21052657" type="General" weightage="20" keywordseo="national-tuberculosis-elimination-program" source="keywords">National Tuberculosis Elimination Program</keyword> (NTEP) has undoubtedly played a pivotal role in this, aiming to eradicate TB by 2025 — five years ahead of the global target. By focusing on expanded testing, improved diagnostic tools, and more accessible treatment options, India has achieved high treatment coverage levels despite the challenges.<br /><div type="Article" hostid="261" msid="114732986" title="Air Quality Alert: Nearly 30% of asthma cases tied to fine particulate matter exposure from bad air" mstype="2" mssubtype="0"></div>However, a significant treatment gap remains. The difference between estimated TB incidence and actual diagnoses still affects millions, especially in countries with large populations like India, Indonesia, Pakistan, China, and Myanmar. These five nations together account for about 50% of the global gap in reported TB cases, with India alone responsible for 16% of the discrepancy.<br /><h2>India’s unique position in the global TB fight</h2>As the nation with the largest share of global TB cases, India has a unique and critical responsibility in addressing the disease. The high TB burden in India is tied to several factors, including undernutrition, poverty, and limited access to healthcare in rural areas. Moreover, with 26% of all TB cases globally, India’s battle against TB will significantly impact the global fight. The government’s financial support for TB-affected households also aims to reduce the economic burden of treatment.<br /><br />However, challenges remain, especially with <keyword id="22004277" type="General" weightage="20" keywordseo="multidrug-resistant-TB" source="keywords">multidrug-resistant TB</keyword> (MDR/RR-TB). While treatment success rates for MDR/RR-TB have reached 68%, diagnosing and treating all drug-resistant cases is an ongoing challenge. In 2023, India’s coverage of preventive treatment for TB among people living with HIV and close contacts of TB patients also saw improvements, but underfunding continues to limit the full scope of TB elimination efforts.<br /><h2>Global funding gaps</h2>Global funding shortages for <keyword id="21039793" type="General" weightage="20" keywordseo="TB-prevention" source="keywords">TB prevention</keyword> and treatment are a significant hindrance to progress. Only $5.7 billion of the targeted $22 billion in funding was met in 2023, and for LMICs — where nearly all of the TB burden lies — the available funding falls well short of their needs. The United States remains the largest bilateral donor, and contributions from the Global Fund to Fight AIDS, Tuberculosis, and Malaria are crucial. However, these funds are not enough to meet essential TB service requirements, leaving healthcare systems under-resourced.<br /><div type="Article" hostid="261" msid="114646545" title="Doctors struggle to treat long Covid patients in India; researchers point to inadequate studies" mstype="2" mssubtype="0"></div>Even in 2022, only one-fifth of the $5 billion target for research funding was achieved, as per the report. This underfunding hampers the development of improved diagnostics, drugs, and vaccines, which are crucial to TB prevention and treatment. <br /><br />Moreover, many of the drivers of TB are related to social factors, such as undernutrition, smoking, alcohol use, and diabetes, making it imperative to address these root causes. For instance, almost half of the TB-affected households globally face what the WHO calls "catastrophic costs" in seeking treatment. This burden is particularly severe in India, where low-income families often forgo treatment due to financial constraints.<br /><br />As WHO’s Director-General Dr Tedros Adhanom Ghebreyesus puts it, "The fact that TB still kills and sickens so many people is an outrage, when we have the tools to prevent it, detect it, and treat it.”<br /><br />The WHO’s Global tuberculosis report 2024 can be accessed <a href="https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2024">here</a>.<br />

Tuberculosis dethrones COVID-19 as world’s top infectious killer again; Half of all new cases from India, Indonesia

New Delhi, Aug 17 () The COVID-19 pandemic has given a chance to revisit and structurally re-imagine a robust public health infrastructure for the country, Union Health Minister Harsh Vardhan said on Monday. <p>Speaking at the inaugural session of the two-day Confederation of Indian Industry (CII) Public Health Conference virtually, Vardhan expressed hope that Prime Minister Narendra Modi's goal of a tuberculosis-free India by 2025 would be achieved with the help of industry leaders and the CII. </p><p>A virtual exhibition on Healthcare and the 'CII TB Free Workplaces Campaign' was launched and the 'CII Public Health Report' was also released at the event which was virtually attended by Vardhan, Minister of State for Health and Family Welfare Ashwini Kumar Choubey and Member (Health) NITI Aayog Dr. Vinod K. Paul, among others. </p><p>"This pandemic has given us a chance to revisit and structurally re-imagine a robust public health infrastructure for our country," Vardhan was quoted as saying by a statement. </p><p>Citing India's successful approach in containing and curing this novel health risk, he lauded the country's capacity to turn government schemes into a broader social movement that saw "the complete eradication of small-pox and polio from a time when India contributed 60 per cent of the global cases of polio". </p><p>Recalling his experience as the health minister of Delhi when he organised a campaign to eradicate polio with meagre funds but with the full backing and enthusiasm of prominent leaders of the industry, Vardhan said he has been witnessing "the same enthusiasm and commitment in eradicating tuberculosis bacilli from the country". </p><p>On the TB Free Workplaces campaign, Vardhan said, "India with nearly 26.4 lakh Tuberculosis cases continues to have the largest share of the global TB burden". </p><p>"The economic burden of TB is huge in terms of lives, money and workdays lost as it disproportionately affects the poor who live in insanitary conditions and are deprived of calories," Vardhan said. </p><p>He also deliberated on the government's response to this problem by pointing out that "resource allocation for TB in India has witnessed a fourfold increase in the last five years". </p><p>"The prime minister had initiated a big survey for detection of TB cases upon taking office in 2014 itself," he noted. </p><p>Every patient of TB and even those with multi-drug resistant TB are treated free as the entire cost is borne by the government while doctors are incentivised to report TB cases, he added. </p><p>The health minister expressed confidence that the government's boost to health infrastructure through the Ayushman Bharat scheme would similarly eradicate diseases like kala-azar and leprosy and push the Maternal Mortality Rate to near zero. </p><p>In his remarks, Choubey said the Prime Minister's efforts to provide medical care at the grassroots have ushered in "a revolutionary expansion of health infrastructure in the rural areas". </p><p>"The intensive use of Telemedicine is clearly evident from the 1.5 lakh consultations already recorded on the e-Sanjeevani tele-consultation platform," he said. </p>Dr Randeep Guleria, Director, All India Institute of Medical Sciences, in his capacity as Chairman – CII Public Health Council and Chandrajit Banerjee, Director General, Confederation of Indian Industry (CII) were also digitally present on the occasion. ASK TDS RDM RDM

COVID-19 has given chance to structurally re-imagine public health infrastructure: Harsh Vardhan

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Tuberculosis dethrones COVID-19 as world’s top infectious killer again; Half of all new cases from India, Indonesia

Ankush Banerjee

COVID-19 has given chance to structurally re-imagine public health infrastructure: Harsh Vardhan

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