SYLLABUS
GS-2: Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.
Context: The global tuberculosis (TB) incidence rate declined by 1.7% between 2023 and 2024, according to the World Bank’s Global TB Report 2025.
Key Findings of the Report
- Global Burden and Mortality
- Tuberculosis (TB) continues to be one of the top 10 causes of death worldwide and the leading cause from a single infectious agent.
- In 2024, an estimated 10.7 million people developed TB, and 1.23 million died. The global incidence rate stood at 131 per 100,000 population, with a case fatality rate of 11.5%.
- Country Distribution and Demographics
- The 30 high TB-burden countries accounted for 87% of global TB cases, with the top eight — India, Indonesia, the Philippines, China, Pakistan, Nigeria, DR Congo, and Bangladesh — contributing 67% of all cases.
- By demographic distribution, men (54%) were most affected, followed by women (35%) and children (11%).
- Chronological Trends
- From 2015 to 2024, global TB incidence decreased by 12% (target: 50% by 2025, 80% by 2030), and deaths fell by 29% (target: 75% by 2025, 90% by 2030).
- Between 2023 and 2024 alone, incidence declined by 1.7% and deaths by 3%, marking the first global decline in total TB cases since 2020.
- Regional Success Stories
- WHO African Region: 28% decline in incidence and 46% reduction in deaths.
- WHO European Region: 39% decline in incidence and 49% reduction in deaths.
- 101 countries achieved at least a 20% reduction in TB incidence, and 65 countries reduced deaths by over 35%.
- Diagnosis and Treatment Progress
- 8.3 million people were newly diagnosed in 2024, representing 78% of all estimated cases.
- 164,545 people received treatment for rifampicin-resistant TB (RR-TB), covering 42% of estimated cases.
- Treatment success: 88% for drug-susceptible TB and 71% for RR-TB.
- Between 2000 and 2024, 83 million lives were saved through TB treatment.
- Preventive Treatment (TPT)
- In 2024, 5.3 million people received TB preventive therapy — 3.5 million contacts of TB patients and 1.8 million people with HIV.
- Coverage reached 58% among people with HIV and 25% among household contacts, showing a modest improvement over the previous year.
- Economic and Social Barriers
- Economic vulnerability remains a significant barrier. Around 50% of TB-affected households experience catastrophic expenditure, exceeding 20% of annual income.
- Most high-burden countries have less than 50% coverage of social protection, and their Universal Health Coverage (UHC) Service Index ranges between 40–60 (out of 100).
- Research, Innovation, and Funding Gaps
- There are currently 18 TB vaccine candidates in clinical development, including six in Phase 3 trials.
- However, the global TB response faces critical funding shortfalls. In 2024, only US$5.9 billion was available for TB prevention, diagnosis, and care — just 27% of the US$22 billion needed by 2027.
- Similarly, TB research funding in 2023 stood at US$1.2 billion, meeting only 24% of the US$5 billion target.
- Further cuts in International donor funding from 2025 threaten progress, underscoring the urgency for stronger domestic financing and political commitment, particularly in high-burden nations.
- India’s Situation and Progress
- India made strong gains in TB reduction, cutting incidence by 21% since 2015, but still accounted for 25% of global TB cases in 2024, topping the list of countries with the highest TB burden.
- Mortality rate reduced from 28 per lakh (2015) to 21 per lakh (2024).
- Incidence rate dropped from 237 per lakh (2015) to 187 per lakh (2024).
- Treatment coverage improved to 92% of estimated patients (up from 85% in 2023 and 53% in 2015).
- The TB Mukt Bharat Abhiyan, which was launched in December 2024, screened over 19 crore people, detecting 24.5 lakh TB cases, including 8.61 lakh asymptomatic infections.
- India accounted for 32% of global multidrug-resistant TB (MDR-TB) cases in 2024.
- People with MDR or rifampicin-resistant TB represented 3.2 per cent of the total TB burden in 2024.
- Despite commendable progress, India remains far from achieving its 2025 elimination goal of reducing incidence by 80% (44 cases per lakh) and deaths by 90% (3 deaths per lakh).
Key Recommendations
- Strengthen and Expand Diagnostic and Treatment Services: Accelerate scale-up of universal access to rapid and molecular diagnostic testing to close the diagnostic gap, ensuring all presumptive TB cases are tested promptly.
- Enhance Preventive Therapy and Vaccination Efforts: Scale-up TB preventive treatment (TPT), particularly among high-risk groups such as household contacts and people living with HIV, aiming to reach WHO targets of near-universal coverage.
- Mobilize and Sustain Adequate Funding: Close the critical funding gaps for TB prevention, diagnosis, treatment, and research. Current funding levels represent only about a quarter of global targets.
- Advance Multisectoral and Community Engagement: Expand community-based TB screening, leverage digital surveillance systems for better case tracking and patient support systems to improve case detection and treatment adherence.