India's Fight Against Tuberculosis (TB) Through the Decades
- Tanu Sharma
- Feb 26
- 6 min read
Tuberculosis (TB) remains one of the deadliest infectious diseases in the world, and India bears the highest burden. Despite being preventable and curable, TB continues to affect millions, causing severe health, social, and economic challenges. Since independence in 1947, the Government of India has implemented various policies and programs to combat TB, evolving from basic control measures to comprehensive strategies integrating modern technology and community participation. This blog explores the key policies and initiatives taken by the Indian government to eliminate TB and their impact on public health.
Early Efforts: 1947-1962
Before the launch of a formal TB control program, the Indian government took several steps to address the growing burden of tuberculosis. The BCG vaccination program was introduced in 1948, with mass immunization campaigns beginning in 1949 with the support of WHO and UNICEF. During the 1950s, the government expanded TB sanatoriums and hospitals, providing free treatment to patients. The introduction of antibiotics like Streptomycin and Isoniazid marked a shift from isolation-based treatment to medical therapy. These early efforts laid the foundation for the National TB Program (NTP) in 1962, India's first structured initiative to combat tuberculosis.
National TB Program (NTP) – 1962
After independence, TB was one of the most significant public health concerns in India. The National TB Program (NTP) was launched in 1962 with the primary objective of diagnosing and treating TB through government-run health centers. However, due to inadequate infrastructure, lack of community engagement, and limited accessibility to treatment, the program failed to make a substantial impact.
Revised National Tuberculosis Control Program (RNTCP) – 1997
Recognizing the limitations of NTP, the Indian government revamped the program, launching the Revised National Tuberculosis Control Program (RNTCP) in 1997. The RNTCP introduced the Directly Observed Treatment, Short-course (DOTS) strategy, which ensured that patients completed their treatment under medical supervision. This approach significantly improved treatment adherence and reduced TB-related mortality.
Key Features of RNTCP:
Standardized treatment regimen
Free TB diagnosis and medication
Monitoring and supervision to prevent drug resistance
Integration with primary healthcare services
RNTCP Phase II (2005-2012)
Building on the success of RNTCP, Phase II was launched in 2005 with additional measures:
TB-HIV collaborative activities focus on integrated screening and treatment services for patients suffering from both diseases.
Public-private partnerships enhance the involvement of private healthcare providers in TB care.
The introduction of drug-resistant TB treatment includes expanding facilities for diagnosing and treating multidrug-resistant and extensively drug-resistant TB.
Enhanced case detection strategies strengthen laboratory networks to improve early diagnosis.
The second phase significantly improved TB detection rates and treatment success, setting the foundation for future elimination programs.
National Strategic Plan (NSP) for TB Elimination (2017-2025)
In line with the global End TB Strategy by the World Health Organization (WHO), India launched the National Strategic Plan (NSP) for TB Elimination 2017-2025 with an ambitious goal of eliminating TB by 2025, five years ahead of the global target.
Key Features of NSP 2017-2025:
Active Case Finding focuses on identifying TB cases in high-risk populations.
The Nikshay Ecosystem is a digital platform designed to track TB patients and monitor treatment outcomes.
Private sector engagement encourages healthcare providers to report and treat TB cases.
Patient support initiatives include nutritional assistance through Nikshay Poshan Yojana, providing ₹500 per month to TB patients.
The expanded drug regimen introduces Bedaquiline and Delamanid for drug-resistant TB cases.
Community involvement strengthens TB champions and enhances engagement efforts.
TB-Free India Campaign (2020-Present)
As part of India’s commitment to ending TB, the TB-Free India Campaign was launched to create mass awareness and mobilize communities. The campaign aligns with the broader Ayushman Bharat Health and Wellness Centers (HWCs) initiative, ensuring TB care is integrated into primary healthcare.
Major Actions Under TB-Free India Campaign:
TB Mukt Bharat Abhiyan promotes community-driven TB awareness campaigns.
Corporate and civil society partnerships engage businesses and NGOs in TB prevention efforts.
Strengthened diagnostic facilities enhance TB detection through advanced tools like CBNAAT and TrueNat.
Key Government Initiatives for TB Elimination
Nikshay Poshan Yojana (2018)
Recognizing the link between nutrition and TB recovery, the Nikshay Poshan Yojana was launched in 2018 to provide direct financial support to TB patients. Under this scheme, every TB patient registered in the government’s Nikshay portal receives ₹500 per month during the course of treatment. This amount helps them afford nutritious food, which is crucial for building immunity and ensuring better treatment outcomes. As of recent reports, millions of TB patients have benefited from this scheme.
Universal Drug Sensitivity Testing (2019)
One of the major challenges in TB treatment is drug resistance, which occurs when TB bacteria become resistant to standard medications. To address this, the Government of India introduced Universal Drug Sensitivity Testing (UDST) in 2019. This ensures that every newly diagnosed TB patient undergoes drug resistance testing before starting treatment. This initiative has significantly improved treatment outcomes by ensuring that patients receive the correct drug regimen from the very beginning.
National TB Prevalence Survey (2019-2021)
India conducted its first-ever National TB Prevalence Survey from 2019 to 2021 to get an accurate picture of the disease burden across different states and regions. This large-scale survey helped the government assess undetected TB cases, treatment gaps, and the effectiveness of existing programs. The data collected from over 500 districts provided crucial insights into the geographic spread of TB, high-risk populations, and the impact of socioeconomic factors on TB prevalence. The survey results have since guided policy decisions, helping the government implement targeted interventions for TB elimination.
Pradhan Mantri TB Mukt Bharat Abhiyan (2022)
Launched in 2022, the Pradhan Mantri TB Mukt Bharat Abhiyan is a community-driven initiative aimed at eradicating TB through citizen participation. The program encourages individuals, corporations, and community groups to adopt TB patients by providing nutritional and emotional support. This initiative enhances treatment adherence, reduces stigma, and fosters a collective responsibility towards TB elimination.
100-Day Accelerated TB Elimination Campaign (2024)
In 2024, the Indian government launched an intensive 100-day campaign focusing on rapid screening, diagnosis, and treatment of TB patients. The campaign aims to:
Conduct door-to-door screenings to identify undiagnosed cases
Ensure immediate initiation of treatment for all diagnosed patients
Strengthen diagnostic facilities in high-burden areas
Increase public awareness through campaigns and community engagement
Challenges in TB Elimination
Despite these extensive measures, several challenges hinder TB elimination:
Delayed diagnosis remains a challenge as many cases go undetected due to lack of awareness and stigma.
Treatment adherence issues arise when patients fail to complete the full course, increasing the risk of drug-resistant TB strains.
Social stigma discourages TB patients from seeking timely medical help, leading to further transmission.
Limited resources make it difficult to provide advanced diagnostic tools and medications, especially in rural areas.
Co-infections with HIV and diabetes complicate TB treatment and require integrated healthcare approaches.
The Road Ahead: What More Needs to be Done?
While India has made remarkable progress in TB control, achieving complete elimination requires:
Strengthening primary healthcare by equipping every health center with proper TB diagnosis and treatment facilities.
Expanding private sector collaboration to involve more hospitals and clinics in TB control efforts.
Enhancing community engagement by mobilizing local organizations, schools, and colleges to spread TB awareness.
Promoting research and innovation to develop new vaccines, improved diagnostics, and more effective drug regimens.
Conclusion
India has come a long way in its battle against TB, from early detection programs in the 1960s to the ambitious goal of TB elimination by 2025. While challenges remain, continuous government efforts, technological advancements, and community participation offer hope for a TB-free future. With collective action, strengthened policies, and public awareness, India can achieve its goal of eradicating TB and ensuring a healthier nation for future generations. Tuberculosis: A Call to Action for Indian Youth - Join the Movement!
Health Volunteers is actively working to support India’s TB elimination goals and empower youth through the Youth Against TB campaign. Together, we can turn this vision into reality. Join us today to create a TB-free future where no one is left behind.
Let’s unite for a healthier, stronger India—because the fight against TB starts with you.
References
Ministry of Health and Family Welfare (MoHFW), Government of India - National Strategic Plan for TB Elimination (2017-2025).
World Health Organization (WHO) - Global TB Report 2023.
Central TB Division, MoHFW - Nikshay Poshan Yojana Guidelines.
Indian Council of Medical Research (ICMR)-National TB Prevalence Survey 2019-2021.
Pradhan Mantri TB Mukt Bharat Abhiyan - Official Campaign Guidelines, 2022.
TB-Free India Campaign - Government Initiatives and Community Participation Reports.
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