"India planned to eliminate TB by 2025, but it’s estimated half a million Indians are still dying from it every year", says two researches, Rajib Dasgupta of Jawaharlal Nehru University and Jens Seeberg of Aarhus University.
According to their survey-based research findings, in India in 2021, an estimated 504,000 people died from tuberculosis ( TB). That’s almost one per minute. More than a quarter of the estimated TB cases worldwide are in India.
In 2018, the UN committed to end the TB epidemic globally by 2030. The “End TB” strategy sought to reduce TB incidence by 80%, deaths by 90%, and eliminate catastrophic costs for TB-affected households. India announced it would try to eliminate TB in India by 2025, five years ahead of the UN’s target.
However, the first TB survey since the 1950s was recently conducted, and it found rates in the Indian community are much higher than anticipated.
When India gained independence in 1947, there were about half a million TB deaths annually and an estimated 2.5 million Indians suffered from active tuberculosis.
In 1948, a TB vaccination program commenced. The BCG vaccine protects against the most severe forms of TB, such as TB meningitis in children, but it doesn’t protect against TB in adults.
India’s first national survey of TB, conducted from 1955 to 1958, found on average four of every 1,000 people in India had TB.
The National Tuberculosis Institute was established in 1959 and an interdisciplinary group of epidemiologists, tuberculosis specialists, microbiologists, biostatisticians, sociologists, public health nurses and X-ray engineers conducted a series of research studies that culminated in the National Tuberculosis Programme in 1963. The key strategy of the program was to use chemotherapy to treat TB.
The results of the most recent national TB survey in India (2019–21) have just been released, and found just over three people per 1,000 had active TB cases. This is not a great improvement on the last survey from the 1950s (four per 1,000) and much higher than the WHO’s 2020 estimate of 1.8 per 1,000.
The highest prevalence was in Delhi, at over five per 1,000. Groups with higher prevalence included the elderly, malnourished, smokers, those with alcohol dependence and diabetics.
Despite the plan to eliminate catastrophic costs due to TB, an estimated 7-32% of TB sufferers and 68% of TB sufferers whose infection is resistant to frontline antibiotics experienced catastrophic costs. Catastrophic costs are said to be incurred when the total costs of treatment exceeds 20% of the annual household income.
Mmeanwhile, the total number of TB patients recorded dropped by 25% in 2020, then rose 19% in 2021. This probably indicates TB diagnoses were lost in 2020 during the COVID outbreak. Given hospitals were overwhelmed by COVID cases, people with TB symptoms would have been less able to get care, or would have been hesitant about going to hospital for fear of catching COVID. Even the National Institute of Tuberculosis and Respiratory Diseases (NITRD) was converted into a designated COVID Care Centre in May 2021.