Today, March 24, 2025, the world commemorates World TB Day, a day that marks Dr. Robert Koch’s groundbreaking announcement - on March 24, 1882 - of the discovery of Mycobacterium tuberculosis, the bacillus responsible for the deadly disease tuberculosis (TB). This discovery, which earned Koch the 1905 coveted Nobel Prize in Physiology or Medicine, laid the foundation for understanding infectious diseases and revolutionized medical science. World TB Day serves as a global platform to raise awareness about TB’s devastating impact and renew our collective resolve to end it. This year’s theme, “Yes! We Can End TB!”, resonates deeply with India’s ambitious mission, spearheaded by Prime Minister Narendra Modi, to eliminate TB by 2025—five years ahead of the United Nations Sustainable Development Goals (UN SDGs) target of 2030.
Ending
TB is not just a public health issue, but a development challenge and
opportunity. WHO’s post-2015 End TB Strategy, adopted by the World Health
Assembly in 2014, aims to end the global TB epidemic as part of the newly
adopted Sustainable Development Goals. This aim serves as a blueprint for
countries to reduce TB incidence by 80%, and TB deaths by 90%, and to eliminate
catastrophic costs for TB-affected households by 2030. Looking at the following
statistics which appear on the home page of the World TB Day 2025 website of
WHO, show highly encouraging numbers: “79
million lives saved since 2000 by global efforts to end TB, 10.8 million people
fell ill with TB in 2023 and about 1.25 million people died of TB in 2023”, far
less numbers in comparison with the past. Indian actions and achievements too
have been significant, which will be listed in the later part of the article.
TB: A Historical Perspective & Dr. Robert Koch
and India’s Connection
Mycobacterium
tuberculosis (TB) is a leading cause of morbidity and mortality around the
globe. The widely used TB vaccine, the Bacillus Calmette-Guérin (BCG), which
was initially started in 1908, has helped in controlling the spread of TB in a
limited way. However, the effectiveness of the BCG vaccine was found to be
variable, due to the different strains of the bacteria that are used by
different laboratories in developing the BCG vaccine. Vaccines or antibiotics
the need to end TB is an extremely important goal for the world. Therefore, the
theme for this year’s World TB Day “Yes We Can End TB” resonates with the
government of India to aim for an unprecedented goal of eliminating TB by 2025
- five years ahead of the goal that the UN has set upon itself to end TB.
Elimination of TB is one of the manifestos in the UN SDG – United Nations
Sustainable Development Goals. India is crucial to achieving this goal since we
are the largest contributor to global TB cases and therefore the aim of the
Government to end TB by 2025 is creditable and must be actively supported by
one and all.
Human understanding that
infectious diseases are caused by microbes - bacteria and other microorganisms
– come from the extraordinary research works by scientists like Louis Pasteur
and Robert Koch, who explained the nature of the infectious diseases and the
connection that exist between them and the disease-causing bacteria, including
TB, and other microorganisms.
This profound
understanding opened up research opportunities for scientists to advance
medicines including developing the BCG vaccine for TB. This has helped in the prevention
and treatment of an important group of diseases that are caused by bacteria and
other microorganisms. BCG, Penicillin, and other antibiotics and vaccines
developed over the past few decades that have saved millions of lives owe their
genesis to the fundamental understanding of the nature of the microbial
diseases for which we owe to scientists like Dr Robert Koch.
Around the time Dr Koch
made his discovery of TB (24 March 1882) India was suffering from a devastating
epidemic of cholera. By then Koch was already famous for his work on anthrax
and tuberculosis. Therefore, the Indian government invited him to investigate
the cause of the cholera epidemic. In 1883, Koch arrived in Calcutta (now
Kolkata) and began his research on Cholera. Koch's work in India was
challenging, yet he was able to isolate the cholera bacterium and show that it
was the cause of the epidemic. This was a significant breakthrough, as the
cause of cholera had been a mystery for centuries. Koch's work in India had
broader implications for public health in the country. His research led to the
development of new methods for preventing and treating cholera, which helped
India control the spread of the disease not just in our country but also in
other parts of the world. Koch's contributions to public health in India earned
him the Order of Merit from the British government in 1905.
TB in India: The Scale of the Challenge
India bears the heaviest burden of TB globally, accounting for approximately 27% of the world’s 10.8 million TB cases in 2023, according to the World Health Organization (WHO) Global Tuberculosis Report 2024. In 2023 alone, an estimated 2.55 million people were diagnosed with TB in India, with around 331,000 deaths—a stark reminder of the disease’s toll. Mumbai, often dubbed the "world capital of multidrug-resistant TB (MDR-TB)," exemplifies the crisis, with an estimated 2.5% of new TB cases and 16% of previously treated cases being MDR-TB. Globally, MDR-TB remains a public health threat, with only 2 in 5 affected individuals accessing treatment in 2023. In India, the overuse and misuse of antibiotics have fuelled this resistant strain, posing a significant hurdle to eradication efforts.
Yet, amidst these challenges, India’s progress offers hope. The WHO has recognized India’s remarkable strides: between 2015 and 2023, TB incidence declined by 17.7% (from 237 to 195 cases per 100,000 population)—more than double the global decline rate of 8.3%. TB-related mortality dropped by 21.4% (from 28 to 22 deaths per lakh population) during the same period. These gains reflect a concerted effort under the National Tuberculosis Elimination Programme (NTEP) and Prime Minister Modi’s leadership.
India’s Ambitious Goal: TB-Free by 2025
In 2018, PM Shri Narendra Modi pledged to eliminate TB by 2025, a target far more aggressive than the WHO’s End TB Strategy, which aims to reduce TB deaths by 95% and new cases by 90% between 2015 and 2035. For India, elimination means reducing TB incidence to less than 1 case per 10 lakh population—a Herculean task given the current rate of approximately 195 per 100,000. While some experts argue that 2025 may be too ambitious, the progress made is undeniable and has earned India global acclaim.
The National Strategic Plan (NSP) for TB Elimination 2017–2025 outlines
a multi-pronged approach to achieving the target for TB elimination. They
include Enhanced Diagnostics: Scaling up rapid molecular tests like Xpert
MTB/RIF and Truenat, which detect TB and drug resistance faster than
traditional methods. In 2023, India achieved its target of initiating treatment
in 95% of diagnosed patients. Private Sector Engagement: Notifications from the
private sector rose from 1.9 lakh cases in 2015 to 8.4 lakh in 2023 (33% of
total cases), reflecting improved collaboration. Nutritional Support: The
Ni-kshay Poshan Yojana provides Rs 500 monthly to TB patients, with nearly 1
crore beneficiaries supported. The Pradhan Mantri TB Mukt Bharat Abhiyaan
(PMTBMBA) has mobilized over 1.5 lakh Ni-kshay Mitras (community supporters) to
donate food baskets, addressing undernourishment—a key risk factor affecting
7.44 lakh TB patients in 2022.
A comprehensive all-India 100-Day Campaign has been Launched in December 2024, this initiative identified over 6 lakh TB cases by March 9, 2025, showcasing intensified case-finding efforts. Today Times of India reported that 40,000 new TB cases have been found in 100 days in Maharashtra. This is an encouraging result because more than 10 million people were screened during the period from December 7 2024 to 24 March 2025. The state of Maharashtra has built up a robust infrastructure to implement the TTEB with “thirty-six revenue districts of Maharashtra divided into 80 NTEP districts” with 2025 designated microscopic centres and 795 Nucleic Acid Amplification Test facilities for effective diagnosis of TB. Besides there are also X-Ray devices including hand-held X-Ray devices to ensure that no case of TB goes undetected.
In addition to the above initiatives in Maharashtra, the National TB Elimination Programme (NTEP) has made significant efforts to make India TB-free covering all states and UTs. The incidence rate of TB in India has shown a 17.7% decline from 237 per 100,000 populations in 2015 to 195 per 100,000 populations in 2023. TB deaths have reduced by 21.4% from 28 per lakh population in 2015 to 22 per lakh population in 2023. To achieve the target of TB elimination, various concentrated efforts have been initiated by all the states and Union Territories in India under the NTEP, some of which include:
- Provision of free drugs and diagnostics to TB patients.
- Active TB case-finding through campaigns in key vulnerable and co-morbid populations.
- Integration of
Ayushman Arogya Mandir with TB screening and treatment services.
- Private sector
engagement with incentives for notification and management of TB cases.
- Scale up of molecular diagnostic laboratories to sub-district levels.
- Expansion of coverage under Ni-kshay Poshan Yojana for nutritional support to TB patients.
- Intensified Information, Education & Communication (IEC) interventions to reduce stigma, enhance community awareness and improve health-seeking behaviour.
- Converge efforts and resources of line ministries for TB elimination.
- Provision of TB Preventive Treatment to contacts of TB patients and vulnerable populations.
- Track notified TB cases through Ni-kshay portal.
- Provide additional nutritional, diagnostic and vocational support to TB
patients and household contacts under Ni-kshya Mitra initiative.
Mumbai’s struggle with Multi Drug Resistance (MDR)-TB highlights both the challenges and innovations in India’s TB battle. The city has scaled up access to advanced diagnostics like GeneXpert and introduced drugs like bedaquiline and delamanid for MDR-TB patients. These efforts, combined with infection prevention and control (IPC) measures under the TB Mukt Bharat IPC project, have reduced transmission in healthcare facilities—a model now expanded to over 100 sites nationwide.
Why World TB Day Matters
World TB Day is more than a commemoration; it’s a call to action. TB remains the world’s leading infectious killer, claiming 1.25 million lives globally in 2023. In India, it’s a silent crisis intertwined with poverty, undernutrition, and co-morbidities like HIV and diabetes (7.7% of TB patients were diabetic in 2023). Awareness campaigns on March 24 remind us that TB is preventable and curable with early diagnosis and adherence to treatment—a message amplified by India’s TB Harega Desh Jeetega campaign.
Looking Ahead: Can India End TB by 2025?
While the 2025 target may be a stretch—given the persistent burden of MDR-TB, gaps in rural healthcare, and socio-economic barriers—India’s progress is a beacon of hope. The WHO praises India’s systematic, tech-driven approach and solid governance, as seen in tools like the Ni-kshay portal for real-time case tracking. The decline in incidence and mortality, coupled with innovations in treatment protocols, positions India as a global leader in TB control.
As we mark World TB Day 2025, let’s rally behind India’s clarion call:
“TB Mukt Bharat!” The journey is tough, but with collective effort—government,
health workers, researchers, and citizens—we can edge closer to a TB-free
future. Dr. Koch’s legacy inspires us, and India’s resolve strengthens us.
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