Gearing up to eliminate tuberculosis

For much of the developed world, Tuberculosis (TB) is a disease of the past. For India, it remains one of the country’s biggest public health and economic challenges. Nearly one in every four TB patients worldwide are from India, making the disease not just a healthcare concern, but a test of the nation’s scientific capability, policy execution and innovation ecosystem. As India is marching towards becoming a developed nation by 2047, eliminating TB is no longer simply about saving lives, it is about reducing healthcare costs and demonstrating India’s ability to solve a global problem through indigenous innovation.

Over the past decade, India has significantly strengthened its fight against Tuberculosis (TB) through the National TB Elimination Programme (NTEP). Although the ambitious 2025 elimination target remains a work in progress, it has accelerated investments in diagnostics, treatment and patient support. The results are encouraging. According to the WHO Global TB Report 2025, India’s TB incidence has declined by 21%, from 237 to 187 cases per lakh population between 2015 and 2024, almost twice the global rate of decline. During the same period, TB mortality fell by 25%, while treatment coverage improved dramatically from 53% to 92%, reflecting stronger case detection and better access to care. Digital platforms such as Ni-kshay, nutritional support through the Ni-kshay Poshan Yojana, expanded molecular diagnostics and nationwide community campaigns under TB Mukt Bharat have together transformed India’s TB response, laying a strong foundation for eventual elimination.

Despite this progress, the battle is far from over. Drug-resistant TB remains a serious threat, requiring longer treatment, higher costs and more complex clinical management. Delayed diagnosis, undernutrition, diabetes, overcrowded living conditions and social stigma continue to fuel transmission. Addressing these issues will require stronger public health systems alongside continued scientific innovation.

Scientific innovation is changing the landscape of TB treatment. New medicines such as Bedaquiline, Delamanid and Pretomanid have significantly improved outcomes for patients with drug-resistant TB by enabling shorter and more effective treatment regimens. Researchers are also working on improved vaccines, rapid diagnostics and host-directed therapies that strengthen the body’s immune response against infection.

India is not merely adopting these innovations; it is actively developing them. The Indian Council of Medical Research (ICMR) and its National Institute for Research in Tuberculosis (NIRT) are leading research on new diagnostics, treatment strategies and disease surveillance. The Department of Biotechnology (DBT) and the Biotechnology Industry Research Assistance Council (BIRAC) are supporting startups and research institutions working on vaccines, diagnostics and novel therapeutics, helping build a stronger indigenous innovation ecosystem.

Indian industry is also playing a crucial role. Companies such as Macleods Pharmaceuticals, Lupin, Cipla and Cadila Pharmaceuticals manufacture affordable anti-TB medicines that are used across India and also exported to many low and middle-income countries. Meanwhile, Molbio Diagnostics has developed the portable Truenat platform, enabling rapid molecular diagnosis even in remote healthcare settings. These achievements reinforce India’s position as not only the "Pharmacy of the world" but also an emerging hub for affordable healthcare innovation. Beyond conventional medicines, Indian scientists are exploring natural and host-directed therapies that could improve TB treatment. Researchers at the CSIR-Indian Institute of Integrative Medicine (IIIM) and the CSIR-Central Drug Research Institute (CDRI) are studying bioactive compounds from medicinal plants such as Ashwagandha, Turmeric, Giloy and Black Pepper for their immune-modulating properties. While these therapies are still under investigation and cannot replace standard treatment, they may eventually complement existing medicines by improving patient recovery. Unlike many Western countries, where TB has become relatively uncommon, India continues to face unique demographic and socio-economic conditions that sustain transmission. High population density, nutritional deficiencies and unequal access to healthcare mean that solutions developed elsewhere may not fully address India’s needs. This makes indigenous innovation essential. Affordable diagnostics, vaccines and medicines designed and manufactured in India will not only strengthen national health security but can also serve other high-burden countries facing similar challenges. The next phase of India’s TB strategy must move beyond disease management to innovation leadership. Greater investment in biotechnology, vaccine development, genomic surveillance and public-private partnerships will be essential to develop affordable, scalable solutions. Equally important will be improving nutrition, sanitation, early diagnosis and awareness, since eliminating TB requires both scientific breakthroughs and stronger community health systems.

India now has an opportunity to redefine its role in the global fight against TB. The country possesses world-class scientific institutions, a robust pharmaceutical industry, and a rapidly growing biotechnology ecosystem. By combining strong public policy with indigenous research and private-sector innovation, India can move beyond managing the world’s largest TB burden to developing solutions for the world. The fight against TB is no longer only about eliminating a disease, it is about demonstrating India’s ability to lead through science, innovation and affordable healthcare. India’s sustained commitment and investment is likely to become a model for TB elimination across the world.

Gobardhan Das is Member, NITI Aayog & Simarjot Kaur is Consultant, NITI Aayog; Views presented are personal.