Some hope

India’s efforts against tuberculosis (TB) have seen remarkable strides, with an 18% decline in incidence and a 25% reduction in deaths over the past decade. Yet, as the World Health Organization’s (WHO) Global Tuberculosis Report 2023 reveals, these achievements fall short of the ambitious target to eliminate TB by 2025. The surge in cases to 8.2 million in 2023 underscores the need for urgent reforms to address the systemic challenges that persist.

A critical bottleneck remains the erratic supply of TB drugs, a recurring issue exacerbated during the pandemic years and far from resolved. Bureaucratic inefficiencies have led to frequent disruptions in drug availability, with government TB centres rationing supplies—a measure that directly undermines patient care. The consequences are dire: interruptions in therapy increase the risk of developing drug-resistant TB strains, further complicating treatment and jeopardizing lives.

This inconsistency is particularly disheartening given India’s near self-sufficiency in TB medicine production. When stocks are steady, patients receive medicines for three months, reducing their dependence on healthcare centres. However, the current gaps force lower-income patients, who comprise the majority of TB sufferers, to make repeated visits or procure costly drugs from private pharmacies. This additional burden is untenable for families already grappling with the socio-economic toll of TB.

The government’s ambitious plan to combat TB in 347 high-burden districts by March 2025 is laudable, but its success hinges on ensuring an uninterrupted supply of medicines. Any failure to address these systemic lapses will not only derail progress but also erode public trust in healthcare systems.

The approval of new therapies for multi-drug-resistant TB offers a glimmer of hope. These treatments have the potential to save lives, especially among the 75,000 individuals afflicted with this more virulent strain annually. However, their effectiveness depends on timely access and consistent supply—a commitment the government must prioritize.

To achieve its TB elimination target, India must strengthen the supply chain management, reduce bureaucratic delays, and increase investments in healthcare infrastructure. The government must also enhance public awareness and community involvement to ensure adherence to therapy, a longstanding challenge.

The fight against TB is not merely a battle against a disease; it is a test of India’s healthcare system and its commitment to its most vulnerable citizens. The stakes are high, but with resolute action and a focus on addressing persistent gaps, India can turn the tide against this ancient scourge.