At 21.4 lakh, India sees 18% spike in TB cases in 2021

A total of 21.4 lakh tuberculosis cases were notified in India in 2021 -- 18 per cent higher than 2020 -- with over 22 crore people screened for the disease across the country for early detection and treatment, according to the World Health Organisation's Global TB report.

Under the Pradhan Mantri TB Mukt Bharat Abhiyan, an initiative of the government, more than 40,000 Nikshay Mitra are supporting over 10.45 lakh TB patients all over the country presently, the Union health ministry said.

The WHO, which released the report on October 27, noted the impact of the COVID-19 pandemic on the diagnosis, treatment, and burden of disease for TB all over the world.

Taking note of the report, the Union health ministry on Friday claimed that India has, in fact, performed 'far better' on major metrics as compared to other countries over time.

"India's TB incidence for the year 2021 is 210 per 100,000 population -- compared with the baseline year of 2015 (incidence was 256 per lakh of population in India); there has been an 18 per cent decline which is 7 percentage points better than the global average of 11 per cent," the ministry said in a statement.

"These figures also place India at the 36th position in terms of incidence rates (from largest to smallest incidence numbers)," it said.

While the COVID-19 pandemic impacted TB programmes across the world, India was able to successfully offset the disruptions through the introduction of critical interventions in 2020 and 2021, which led to the National TB Elimination Programme notifying over 21.4 lakh TB cases -- 18 per cent higher than 2020, the statement said.

The ministry said the success can be attributed to an array of measures implemented in the programme over the years, such as the mandatory notification policy to ensure all cases are reported to the government.

Intense door-to-door Active Case Finding drives to screen patients to ensure that no household is missed, has been a pillar of the programme, the government said.

The aim has been to find and detect as many cases as possible to arrest transmission of the disease in the community, which has contributed to the decline in incidence, it said.

For this purpose, India has also scaled up diagnostic capability to strengthen detection efforts, it said.

Indigenously-developed molecular diagnostics have helped expand the reach of diagnosis to every part of the country today. India has over 4,760 molecular diagnostic machines across the country, reaching every district, the statement said.

Against this backdrop, and before the publication of the global report, the Ministry of Health had communicated to WHO that the ministry has initiated domestic studies to arrive at a more accurate estimate of incidence and mortality rates in a systematic manner and India's data will be provided after conclusion of studies in early part of 2023, the statement said.

The WHO, acknowledging the health ministry's position and in its report, noted that "estimates of TB incidence and mortality in India for 2000-2021 are interim and subject to finalization, in consultation with India's ministry of health and family welfare."

The results of the health ministry's study, initiated by the central TB division, will be available in approximately six months' time and shared with the WHO.

These steps are in line with India conducting its own National Prevalence Survey to assess the true TB burden in the country -- the world's largest such survey ever conducted.

The WHO report notes that India is the only country to have completed such a survey in 2021, a year which saw "considerable recovery in India."

The WHO Report also notes the crucial role of nutrition and under-nutrition as a contributory factor to the development of active TB disease.

In this respect, the TB Programme's nutrition support scheme -- Ni-kshay Poshan Yojana -- has proved critical for the vulnerable.

During 2020-21, India made cash transfers of $89 million (Rs 670 crore) to TB patients through a Direct Benefit Transfer programme, the government said.

Moreover, in September 2022, the President of India launched a first-of-its-kind initiative, Pradhan Mantri TB Mukt Bharat Abhiyan, to provide additional nutritional support to those on TB treatment, through contributions from community and organisations.

Till date, 40,492 donors have come forward to support over 10,45,269 patients across the country, the statement said.