India – Tuberculosis Situation (WHO Global TB Report 2025)

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Number of people developing TB

The total of 10.7 million (95% UI: 9.9–11.5 million) in 2024 was a small (1%) reduction from 10.8 million (95% UI: 10.0–11.6 million) in 2023. It remained above the level of 10.3 million (95% UI: 9.6– 11.0 million) in 2020. The 30 high TB burden countries4 accounted for 87% of all estimated incident cases worldwide, with eight of these countries accounting for two thirds (67%) of the global total: India (25%), Indonesia (10%), the Philippines (6.8%), China (6.5%), Pakistan (6.3%), Nigeria (4.8%), the Democratic Republic of the Congo (3.9%) and Bangladesh (3.6%). The top five countries accounted for 55% of the global total.

1. India’s Global Position

India accounts for 25% of the global TB burden — the highest share of any country in the world.
Together with Indonesia, the Philippines, China, Pakistan, Nigeria, the Democratic Republic of the Congo, and Bangladesh, these eight countries account for 67% of global TB cases.
India remains among the 30 High TB Burden Countries (HBCs) for 2021–2025, and also appears in the HIV-associated TB and MDR/RR-TB lists.

2. Burden of Disease in India (2024 data)

Incidence category: 187 (160–218) new cases per 100,000 population per year (Category 3 – endemic).
India contributes roughly 2.68 million (2.5–2.8 million) incident TB cases annually (estimated).
TB incidence in India has stabilized compared to 2023 but remains a major contributor to the global total.

3. Case Detection and Notification

In 2024, the gap between estimated TB incidence and diagnosed cases remains significant but improving.
India notified over 96% of estimated incident TB cases, placing it among the best-performing high-burden countries for case detection (alongside Bangladesh, Brazil, Ethiopia, Kenya, Mozambique, Uganda, and Zambia).
Despite progress, India still contributed to 8.8% of the global “missing” TB cases — people who developed TB but were not officially diagnosed or reported.

4. Drug-Resistant TB (MDR/RR-TB)

India is the largest contributor to the global MDR/RR-TB burden, accounting for 32% of global MDR/RR-TB cases in 2024.
Estimated proportion of MDR/RR-TB among new TB cases: ~3.2%, a decrease from 4.7% (95% UI: 3.5–6.0%) in 2015 worldwide.
Among previously treated cases, MDR/RR-TB prevalence is ~16%, This was down from 19% (95% UI: 10–28%) in 2015., indicating ongoing transmission and treatment challenges.
India, China, the Philippines, and the Russian Federation together make up over 50% of global MDR/RR-TB cases.
ines (7.1%) and the Russian Federation (6.7%) (Fig. 8). The highest proportions of people with TB who had MDR/RR-TB (>50% of previously treated cases in 2023) were found in Eastern Europe and Central Asia.

5. TB Mortality in India

Globally in 2024, TB caused an estimated 1.23 million, deaths (95% UI: 1.13–1.33 million), including 1.08 million among HIV-negative people (95% UI: 0.99–1.18 million) and 150 000 among people with HIV (95% UI: 120 000– 183 000).1 This total was down from 1.27 million (95% UI: 1.17–1.38 million) in 2023, 1.42 million (95% UI: 1.29–1.55 million) in 2019 (pre-pandemic) and a 42% reduction from 2.13 million (95% UI: 1.91–2.35 million) in 2010. The case fatality rate was 11.5%.
India remains among the countries with the highest number of TB deaths , accounting for 28% of deaths globally, though mortality continues to decline.
Updated cause-of-death data from India’s Sample Registration System (SRS) 2020 and 2022 were incorporated into WHO’s dynamic modeling for TB incidence and mortality in 2025.
Despite the decline, TB remains one of the leading causes of death from infectious disease in India.

6. TB and HIV Co-infection

India continues to report HIV-TB co-infection but at relatively low levels compared with African countries.
High ART (antiretroviral therapy) coverage among HIV-TB co-infected patients (around 90% globally in 2024) contributes to better outcomes.
Deaths from TB among people with HIV have been declining for many years and by 2024 had fallen 76% compared with 2010 worldwide.

7. Treatment Success and Outcomes

Treatment success rate (drug-susceptible TB) in India is around 90 %, consistent with the global average.
Expansion of rapid diagnostics and shorter, all-oral MDR-TB regimens has improved outcomes since 2023.
Five countries accounted for about 60% of the gap between the estimated global number of people who developed MDR/RR-TB in 2024 (incident cases of MDR/ RR-TB) and the global number of people enrolled on treatment in 2024. Listed in order of their share of the global gap, these countries were India (33%), the Philippines (9.3%), Indonesia (7.3%), China (6.1%) and Pakistan (4.1%).

8. TB Funding and Health System Context

India, as part of the BRICS group (Brazil, Russia, India, China, South Africa), funds nearly all TB activities domestically, with 97 % of TB spending coming from national resources.
This domestic funding has insulated India’s TB program from global donor funding cuts in 2025 that affected many low-income countries.
The National TB Elimination Programme (NTEP) continues to drive screening, notification, and treatment expansion through both public and private sectors.
Of the 30 high TB burden countries, estimates of the percentage of the population facing catastrophic health expenditures are particularly high (≥15% of the population) for Angola, Bangladesh, China, India, Nigeria, Sierra Leone and Uganda.

9. Data Systems and Research

India maintains one of the most robust TB surveillance systems globally.
National TB Inventory Study (2019–2021) and National Drug Resistance Surveys (2016, 2024) contribute to WHO’s global modeling.
India’s surveillance incorporates mortality data (SRS), inventory studies, and prevalence data for comprehensive disease modeling.

10. Progress Toward End TB Strategy Goals

Among the 30 high TB burden countries, most made progress in service coverage between 2000 and 2019. The largest gains in absolute terms (+30 index points or more) were in China, India, Myanmar, Thailand and Viet Nam.
End TB Milestone (2025) targets:
- 50% reduction in incidence and 75% reduction in deaths (relative to 2015).
India has not yet met these milestones but shows steady progress in incidence reduction and improved detection.
Key achievements:
- Enhanced access to rapid diagnostics (GeneXpert, Truenat).
- Shorter all-oral MDR-TB regimens introduced.
- Integration of TB-HIV services and nutrition support (Nikshay Poshan Yojana).

11. Future Outlook

WHO notes India’s central role in global TB control, emphasizing:
- Continued investment in TB research and vaccines.
- Strengthened surveillance and cause-of-death reporting.
- Sustained domestic funding despite shrinking donor aid.
India’s dynamic model updates (2025) will guide new global TB burden estimates for 2026–2030.

🔍 Summary Table – India (WHO TB Report 2025)

Indicator	Value / Rank (2024)
Global share of TB cases	25% (highest worldwide)
Incidence rate	100–299 per 100,000
Estimated incident cases	~2.7 million
Estimated MDR/RR-TB share	32% of global MDR/RR-TB cases
Treatment success (DS-TB)	≈90%
Funding source	~97% domestic
HIV-TB coinfection	Low (<5%)
TB deaths	High but declining
Reporting coverage	>80% of estimated cases

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About Post Author

Dr Akshay Minhas

MD (Community Medicine) PGDGARD (GIS) Assistant Professor Dr. Rajendra Prasad Government Medical College (DR.RPGMC), Tanda Kangra, Himachal Pradesh, India

[email protected]

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