WHO released the Global TB Report 2022 on 27 October 2022. The report notes the impact of the COVID-19 pandemic on the diagnosis, treatment and disease burden of TB worldwide. The Ministry of Health and Family Welfare took note of the WHO Global TB Report 2022 released on 27 October 2022 and clarified that India has actually performed much better than other countries in key indicators over time. The incidence of TB in India for 2021 is 210 per 100,000 population – compared to the baseline year of 2015 (incidence was 256 per 100,000 population in India); there was a decrease of 18%, which is 7 percentage points better than the global average of 11%. These numbers also rank India 36th in terms of incidence rate (from largest to smallest).
COVID-19 pandemic affected TB programs worldwide
While the COVID-19 pandemic affected TB programs worldwide, India was able to successfully offset the disruptions caused by implementing critical interventions in 2020 and 2021 – resulting in the National TB Elimination Program reporting more than 21.4 million TB cases – 18% higher than in 2020. This success can be attributed to a number of forward-looking measures that the program has implemented over the years, such as a mandatory reporting policy to ensure that all cases are reported to the government. Further, a pillar of the program is intensified active door-to-door case-finding to screen patients and ensure that no household is missed. In 2021, over 22 million people were screened for TB.
The goal was to find and detect more cases to stop further transmission of the disease in the community, which contributed to a decrease in incidence. To this end, India has also increased diagnostic capacity to strengthen detection efforts. Homegrown molecular diagnostics have helped to extend the reach of diagnostics to all parts of the country today. India has more than 4,760 molecular diagnostic machines across the country, reaching every district.
In this context, and prior to the publication of the Global Report, the Ministry of Health and Welfare informed WHO that the Ministry had already started domestic studies to arrive at a more accurate estimate of incidence and mortality in a systematic way. India’s data will be provided after the studies are completed in early 2023. WHO also acknowledged the Ministry of Health’s position on the matter, noting in the report that “the estimates of TB incidence and mortality in India 2000-2021 are provisional and subject to finalization in consultation with the Indian by the Ministry of Health and Family Welfare”.
The results of the Ministry of Health study initiated by the Central TB Division (CTD) will be available in about six months and will be further shared with the WHO. The moves come in line with India conducting its own national prevalence survey to assess the country’s true burden of TB – the largest such survey ever conducted in the world. The WHO report said India is the only country to have completed such a survey in 2021, a year in which there has been a “significant recovery in India”.
The WHO report also points to the crucial role of nutrition and malnutrition as a factor contributing to the development of active TB disease. In this regard, the TB Program’s nutritional support scheme – Ni-kshay Poshan Yojana – has proved crucial for the vulnerable. During 2020 and 2021, India made cash transfers of $89 million (INR 670 million) to TB patients through the Direct Benefit Transfer Program.
Additionally, in September 2022, the Honorable President of India launched a first-of-its-kind initiative, the Pradhan Mantri TB Mukt Bharat Abhiyan, which provides additional nutritional support to those undergoing TB treatment through contributions from the community including individuals and organizations. Till date, 40,492 donors have come forward to support more than 10,45,269 patients across the country.
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