India will fail to meet 2025 TB ‘elimination’ target

In March 2018, Prime Minister Narendra Modi set an ambitious goal of “eliminating” TB by 2025, five years ahead of the United Nations Sustainable Development Goals (SDG) deadline set for 2030. Mr. Modi reiterated the government’s goal of “eliminating” TB by 2025 even in March 2023 while inaugurating the One World TB Summit 2023 in Varanasi.

The SDG targets for 2030 is 90% reduction in TB deaths compared with 2015 and 80% reduction in TB incidence compared with 2015. As per WHO’s post-2015 End TB Strategy, compared with 2015, countries are required to meet the 2025 milestones of reducing TB deaths by 75%, and reducing TB incidence rate by 50%. But as per the WHO Global TB Report 2024 and the India TB Report 2024 released a few days ago, India will not be able to even meet the 2025 milestones set by the WHO End TB Strategy, let alone achieving the ambitious goal of “eliminating” TB by 2025.

According to the India TB Report 2024, the TB incidence rate in India in 2015 was 237 per 1,00,000 population and the mortality rate was 28 per 1,00,000 population in 2015. According to the WHO global TB report 2024, the TB incidence rate for India in 2023 was 195 per 1,00,000 population. It was 199 per 1,00,000 in 2022. In the case of TB mortality, the rate was 22 per 1,00,000 population in 2023, down from 23 per one lakh in 2022. As per the WHO global TB report 2024, the TB incidence rate in India had reduced by 18% between 2015 and 2023, while the reduction in the total number of TB deaths between 2015 and 2023 was only 24%.

Since the End TB Strategy 2025 milestone requires 75% reduction in the total number of TB deaths and 50% reduction in TB incidence, India has to reduce the TB death rate from 28 per 1,00,000 in 2015 to seven per 1,00,000 by 2025 and the TB incidence rate from 237 per 1,00,000 in 2015 to 118.5 per 1,00,000 by 2025. Not only will India fail to “eliminate” TB by 2025, it will not even be able to meet even the End TB Strategy 2025 milestones for TB incidence and the total number of TB deaths.

Worse, even in 2023, India has not met the 2020 milestones of the End TB Strategy for both TB incidence and deaths. As per the End TB Strategy target for 2020, there should have been a 35% reduction in the number of TB deaths compared with 2015 and 20% reduction in TB incidence rate compared with 2015. With only 24% reduction in the total number of TB deaths and 18% reduction in TB incidence between 2015 and 2023, India has not even met the 2020 milestones for TB deaths and TB incidence even three years after the 2020 target date.

Not only will India fail to meet the End TB Strategy 2025 milestones, India did not meet the ‘elimination’ targets set for 2023 by the India’s National Strategic Plan for TB elimination: 2017-2025 report published in 2017 — reducing the estimated TB incidence rate per lakh population to 77, and reducing the estimated TB deaths per 1,00,000 population to six.

Despite the very slow progress in reducing TB incidence and deaths and far from “eliminating” TB by 2025, a November 5 PIB release says India achieved a “noteworthy 17.7% decline in TB incidence from 2015 to 2023, a rate that is over twice the global average decline of 8.3%”, as reported by the WHO Global TB Report 2024.