India's TB Care: Challenges, Tech, and Patient-Centric Approaches Discussed

To commemorate World Tuberculosis Day on March 24, The Hindu recently hosted a webinar titled "World TB Day: Towards Patient-Centric and Tech-Enabled TB Care" on March 20, 2026. This significant event brought together leading experts to deliberate on various facets of tuberculosis (TB) care and the persistent challenges faced in India. Ramya Ananthakrishnan, Director of REACH (Resource Group for Education and Advocacy for Community Health), initiated the discussion by providing a comprehensive overview of tuberculosis. She covered its symptoms, available diagnostic tools, classification, current treatment regimens, and highlighted the pivotal role of 'TB champions' – individuals who advocate for and support others affected by the disease. Ananthakrishnan shared alarming statistics, stating that as of 2023-2024, approximately 2.5 million people in India were identified with tuberculosis, and tragically, one person succumbs to TB every five minutes in the country. She also detailed the Indian government's robust efforts under the National Tuberculosis Elimination Program (NTEP), mentioning that every TB patient, irrespective of whether they receive treatment in the public or private sector, is notified to a central portal called 'Ni-kshay'. Furthermore, every registered patient is eligible for a direct benefit transfer (DBT) of ₹1,000 per month, aimed at providing nutritional and financial support during their arduous treatment journey. A recent advancement she highlighted was the implementation of TB Preventive Therapy for all eligible household contacts, a crucial step in breaking the chain of transmission. Ananthakrishnan meticulously outlined several key challenges impeding TB elimination efforts in India. These include the significant delay in individuals seeking care, the pervasive social stigma associated with TB, barriers to accessing timely diagnosis and effective treatment, issues related to patient adherence to the often-long treatment period, and the limited effectiveness of existing vaccines. These challenges are further compounded by issues such as inadequate infrastructure, a shortage of trained healthcare professionals, and disparities in healthcare access across different regions of India. The COVID-19 pandemic also caused considerable disruption to TB control programs, leading to delays in diagnosis and treatment, particularly affecting vulnerable populations. Rhea Lobo, a TB survivor and former Board Member of the Community Delegation to the Stop TB Partnership, underscored the indispensable role of community engagement in the overall TB response. She acknowledged India's leadership in demonstrating political will to eradicate TB but stressed the necessity for consistent and sustained action. Lobo pointed out that India carries the highest burden of TB globally and emphasized the urgent need to adopt shorter treatment regimens. She specifically mentioned the availability of a four-month drug-sensitive TB regimen, recommended by the World Health Organisation for selected patients, which is available internationally. Globally, India accounts for a significant portion of all estimated incident TB cases, with some reports indicating as high as 26% of the global burden in 2023. Animesh Sinha, Advisor with Médecins Sans Frontières, focused on the significant advancements in TB treatments and the transformative role of research, innovation, and technology in enhancing patient outcomes. He highlighted a major paradigm shift in recent years towards shorter, all-oral treatment regimens, particularly for those with drug-resistant TB. A patient-centered approach for drug-resistant TB, as Sinha explained, typically involves rapid diagnosis and immediate drug susceptibility testing. This ensures that patients are not subjected to ineffective treatments for prolonged periods, facilitating early identification of resistance and a prompt switch to effective therapeutic options. He stressed the importance of providing timely treatment without unnecessary referrals or delays. Sinha further elaborated on the growing integration of technology in TB care, particularly in India. This includes the utilization of digital tools, improved diagnostics, and data-driven programs. Technology, he noted, can intervene at various critical junctures, primarily leading to more accurate diagnoses and faster pathways to cure. The World Health Organization (WHO) also advocates for harnessing synergies between TB response and primary health care (PHC) to deliver equitable, accessible, and people-centered TB services, while addressing the underlying social and economic determinants of health. Despite progress, India still faces challenges like supply chain disruptions for newer, repurposed medicines used in drug-resistant TB treatment, which often depend on global manufacturing partnerships. Timely communication and preparedness planning are essential to ensure continuity of care and prevent treatment interruptions, which can lead to treatment failure and increased drug resistance. This webinar reinforced the complexity of TB elimination and the multi-pronged approach required, combining medical advancements, technological integration, strong community involvement, and sustained political commitment to achieve India's goal of ending TB by 2025 under the ambitious "Detect-Treat-Prevent-Build" model of the NTEP.

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