India's ambitious goal to eliminate tuberculosis (TB) by 2025, five years ahead of the global target, appears challenging with a  new World Health Organization's (WHO) report  pointing out that India accounts for 26% of the global TB burden, the highest among 30 high-burden countries.

As per the Global Tuberculosis Report 2024, globally, TB also emerged as the leading infectious disease killer in 2023, surpassing COVID-19. The WHO reported about 8.2 million new cases of TB, marking the highest incidence since monitoring began in 1995. While India led the list was followed by Indonesia, China, the Philippines, and Pakistan. This also represents a notable increase from 7.5 million reported in 2022.

The top infectious disease was found to be most common among men (55 per cent). Women accounted for more than 30 per cent, while 12 per cent were children and young adolescents.

“The fact that TB still kills and sickens so many people is an outrage, when we have the tools to prevent it, detect it and treat it,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, in the report. He called on countries to “make good on the concrete commitments they have made to expand the use of those tools, and to end TB”.

The report identifies five key risk factors for TB: undernutrition, HIV infection, alcohol use disorders, smoking, and diabetes, stressing the need for multisectoral action to address these issues.

The report said, MDR-TB poses a significant obstacle. Despite treatment success rates reaching 68%, only 44% of those estimated to have MDR-TB were diagnosed and treated in 2023. “Of the 400 000 people estimated to have developed MDR/RR-TB, only 44 per cent were diagnosed and treated in 2023,” the report said.

The complexities involved in managing these cases make eradication efforts more difficult. While the coverage of TB preventive treatment has been sustained for people living with HIV, multidrug-resistant TB remains a public health crisis.

The report calls for increased funding for TB research and sustained efforts to improve treatment success rates for multidrug-resistant TB, which have reached 68%. “Critical determinants like poverty and GDP per capita also require coordinated multisectoral action,” said the report, while calling for increased funding for TB research.

On the positive front, meanwhile, the report noted a decline in the gap between the estimated number of new TB cases and those reported. It narrowed to about 2.7 million, down from Covid pandemic levels of around 4 million in 2020 and 2021.

In March 2018, Prime Minister Narendra Modi had made a commitment to eliminate TB from India by 2025, as the rest of the world aimed to achieve the TB-related Sustainable Development Goals (SDGs) targets by 2030.