World Tuberculosis Day, commemorated each March, traces its origins to 1882, when German physician Robert Koch first identified Mycobacterium tuberculosis — the bacterium behind one of humanity's oldest and most persistent infectious diseases. More than a century later, TB continues to claim millions of lives each year, and India remains central to the global effort to end it.

India accounts for roughly a quarter of the total global TB burden, yet the country's progress over the past decade stands out. According to the WHO Global TB Report 2025, India recorded a 21% percent decline in TB incidence between 2015 and 2024 — nearly twice the pace of decline observed globally. Equally significant is the sharp reduction in "missing cases" — people who contract TB but are never reported to the health system. That figure has fallen from 1.5 million in 2015 to 0.1 million by 2024: real people found, diagnosed, and linked to care who might otherwise have remained invisible to the system.

This progress is a result of sustained political will and effective collaboration across government, healthcare service providers, civil society, the private sector, and communities.

A Government-Led Mission

Over the years, India's TB response has evolved steadily to grow from a public health program into a full-fledged national mission. The senior leadership in the country reviews TB progress directly, elevating it as a pressing development priority. Financial resources committed to the program have grown nearly threefold over the last decade, with a doubling in funding over the last seven years alone. These resources have enabled newer, impactful interventions: deeper private sector engagement, social support for patients, upgraded diagnostic and treatment capacity, and the adoption of digital tools to strengthen patient management.

Additionally, the prioritization of TB elimination by the Government in 2018, to accelerate the country’s progress towards ending TB as an epidemic helped create a mission-mode environment in which TB elimination became a "Jan Abhiyan," a people's movement rather than a government program alone. That shift has fundamentally changed how India approaches detection, treatment, and community engagement.

Finding TB Before It Finds You

In late 2024, the Ministry of Health launched the TB Mukt Bharat Abhiyan (TB-Free India) campaign, with the primary objective of identifying TB cases early, before symptoms appear. The campaign has already screened more than 190 million vulnerable individuals across the country, detecting 2.45 million TB patients — including 861,000 asymptomatic cases.

Making this possible is a new generation of make-in-India diagnostic tools and a vibrant innovator ecosystem. Portable X-ray machines, including those equipped with artificial intelligence for rapid interpretation of lung abnormalities, are now being deployed beyond hospitals and directly into communities. India is also home to the largest TB laboratory network in the world, with over 9,300 rapid molecular testing facilities operating across the country. Post Covid, Indian diagnostic manufacturers and innovators have developed lower cost diagnostic tests, that can help scale up molecular testing. The results are measurable: TB-related deaths have fallen from 28 to 22 per 100,000 people between 2015 and 2023, and the share of presumptive patients receiving recommended molecular testing has more than doubled with a planned roadmap to 100% molecular testing.

Supporting the Whole Person, Not Just the Disease

India-led research has also contributed to strengthening global standards of care. The Reducing Activation of Tuberculosis by Improvement of Nutritional Status or RATIONS trial, led by the Indian Council of Medical Research, demonstrated a direct link between nutrition and TB treatment outcomes. Its findings have subsequently been incorporated into WHO 2025 guidelines on TB and nutrition.

On the ground, the Nikshay Poshan Yojana which provides monthly cash transfers to all TB patients — recently doubled from Rs 500 to Rs 1,000 per month. Between April 2018 and November 2025, more than Rs 4,406 crores have been disbursed to over 13.7 million beneficiaries. Parallelly, the complementary Nikshay Mitra initiative has mobilized more than 700,000 registered volunteers — known as Mitras — who provide nutritional food baskets and sustained support to patients and has expanded to include household contacts. An independent assessment by the Indian Institute of Public Health Gandhinagar found that patients who received a food basket and had a Nikshay Mitra achieved a high 95% percent treatment success rate.

Additionally, India's TB program has also further broadened and customized its response in a couple of keyways including through differentiated care for high-risk patients, newer injection-free treatments for drug-resistant TB, and preventive chemoprophylaxis for household contacts.

Building a People's Movement

However, early diagnosis continues to remain pivotal as it enables timely treatment and limits the spread of TB within communities. The disease demands intervention at every stage: early testing, sustained treatment adherence, management of related conditions, and vigilance against relapse. A patient who begins to feel better halfway through a six-month course of treatment may stop, and that is how drug-resistant TB develops.

Behavioral barriers continue to remain significant. A national prevalence survey conducted in 2021 found that 64% percent of people who showed TB symptoms did not seek testing. The reasons were layered: TB carries a social stigma sustained by misconceptions, a lack of accurate information, and widespread unawareness that prevents care-seeking. Addressing these barriers requires normalizing TB as a treatable disease and reducing stigma through clear, evidence-based communication that encourages timely care-seeking.

At the community level, enabling timely care-seeking depends on building trust and reducing stigma. To this end, survivor voices including TB Champions, are increasingly being mobilized across the TB response, supporting treatment adherence and encouraging punctual treatment-seeking in ways that formal messaging often cannot.

Further, a strong female frontline workforce consisting of ASHAs (Accredited Social Health Activists), auxiliary nurse midwives, and community volunteers — frequently serves as the first point of contact, particularly for vulnerable populations, measurably augmenting other modes of outreach and communication. These efforts are increasingly complemented by differentiated TB care approaches, including support for drug-resistant TB and the expansion of TB preventive therapy.

The Road Ahead

The last decade has built significant increases in notifications, on account of scale up of private provider engagement, direct benefit payments for patients and providers. The current push to — expand molecular testing, community-level screening, differentiated TB care, and a growing movement of survivors and frontline workers represents a national TB response, grounded in political commitment and people's participation.

The subsequent stretch will require easier screening and detection tools, faster diagnosis and simpler treatment protocols, and potentially vaccines that can reduce disease severity or control its spread. All of which seem plausible in the next two decades The trajectory is clear. The task now is to see it through.