Tuberculosis (TB) continues to be one of the most pressing public health challenges, particularly in high-burden countries like India. The risk is prevalent across people of all age groups. That said, the social and economic impact becomes especially severe when the disease strikes working age populations, pushing families into cycles of liabilities like income loss and stigma. India accounts for nearly 25per cent of the global case load, although 87per cent of new TB cases occur in 30 high-burden countries. In 2024 alone, TB claimed nearly 1.23 million lives, making the disease a leading cause of death from cause and one of the top ten causes of mortality globally.
This paradox underscores the urgency of addressing the TB in newer ways.
The Urgency for Reinvention
India needs a new playbook that integrates prevention, technology, stronger partnerships, and system-wide accountability. There is an urgent need for new anti-TB drugs as deaths from TB and cases of multidrug- and extensively drug-resistant TB continue to rise. Multidrug-resistant TB (MDR-TB) remains a major public health challenge, with only about two out of five patients receiving treatment in 2024.
Challenges
TB is often seen primarily as an infectious disease crisis. The burden of TB, however, goes beyond treatment completion. There’s not enough focus on what patients go through after treatment and how their quality of life, productivity levels, and financial stability are affected. Rapid urbanisation presents new challenges for TB control. Most TB narratives are poverty-focused or rural-focused, but the ignored populations must also become part of the conversation, especially people living in urban slums, migrant populations, and those at risk of workplace transmission. These realities can sustain delayed diagnosis, interrupted treatment, and ongoing spread. Preventing TB before it develops into active disease must become a central pillar of elimination efforts.
Innovative Treatments & New Care Models
Early and accurate diagnosis is critical for selecting the most suitable treatment options. According to the World Health Organization (WHO) guidelines, detection of MDR-TB requires bacteriological confirmation and drug-resistance testing, typically using rapid molecular diagnostics or culture-based methods. This makes early and accurate diagnosis critical for selecting the right treatment pathway.
Newer treatments can help in addressing the challenge of multidrug-resistant TB by offering a more effective and shorter treatment pathway. Shorter-course regimens also support paediatric TB care by simplifying treatment protocols and improving adherence. It is important to provide increased access to life-saving TB medicines globally through large- scale manufacturing and partnerships. Backward-integrated manufacturing capabilities and strong supply chains ensure cost efficiencies and sustained access to critical TB therapies.
Digital Health as a Force Multiplier
In a country of India’s scale, digital health can become a powerful force multiplier. Given India’s scale of disease burden, digital health can play a meaningful role in strengthening TB control efforts. Real-time data and surveillance systems help with earlier and more accurate detection, closer monitoring, and better treatment adherence, while also enabling quicker follow-up. Rapid molecular testing has further improved the speed and precision of diagnosis, allowing clinicians to step in sooner. Technology can also aid case detection and timely intervention, especially in settings where speed and coordination are critical.
Shift from Preventive to Predictive Health
Scaling preventive treatment programs is vital in reducing the disease burden over time. Elimination strategies should focus on prevention, especially among high-risk populations like close contacts of TB patients. Further, broader access to preventive therapies, such as paediatric formulations designed for children, can also mitigate critical treatment challenges.
Data-driven insights and predictive health models can help identify high-risk communities and support targeted interventions even before transmission increases. Scaling preventive treatment programs can play a transformative role in reducing TB incidence over time.
System-Level Transformation
TB elimination requires coordinated action across public health systems, global health agencies, and private sector stakeholders. Improved treatment reach is possible by expanding drug registrations and strengthening supply networks. Sustainable healthcare solutions, supported by innovation, partnerships, and long-term investment in research and development, will be critical to accelerating TB elimination efforts. While India has made important progress, reinvention and persistence is the need of the hour. Measured mixes of prevention, innovation, digital tools, stronger care models, and system-wide accountability is what can turn ambition into action and action into elimination.
This authored article was first published in the BW Healthcare on March 25, 2026
