India’s Tuberculosis Elimination Programme

India’s National TB Elimination Programme (NTEP) is the country’s main public health strategy to reduce and eventually eliminate tuberculosis. It combines early diagnosis, prompt treatment, preventive care, digital tracking, and nutritional support to improve outcomes and lower transmission.

Administrative and Strategic Framework

The Revised National Tuberculosis Control Programme, launched nationwide in 1997, was renamed the National TB Elimination Programme in 2020. It is implemented by the Central TB Division under the Ministry of Health and Family Welfare as a centrally sponsored scheme under the National Health Mission.

The programme is guided by the National Strategic Plan for TB Elimination 2017–2025, built around four strategic pillars: Detect, Treat, Prevent and Build. The approach combines molecular diagnostics, daily fixed-dose drug combinations, preventive treatment for vulnerable groups, and strengthening of health systems.

As a centrally sponsored scheme, funding is shared in different ratios depending on the category of state:

• General category states: 60:40 between the Centre and the state.
• Northeastern and Himalayan states: 90:10 between the Centre and the state.
• Union Territories: 100% funding by the Centre.

Elimination Goal and Disease Burden

India defines TB elimination as achieving less than one notified case per million population per year. The national goal was set for 2025, five years ahead of the UN Sustainable Development Goal 3.3, which aims to end the TB epidemic by 2030.

The national strategy uses 2015 as the baseline and targets an 80% reduction in TB incidence, a 90% reduction in TB-related deaths, and zero catastrophic costs for affected households. According to the WHO Global Tuberculosis Report 2025, India has the highest TB burden in the world, accounting for about 25% of global TB cases and 28% of global TB deaths.

India has reported measurable progress in recent years. Between 2015 and 2024, TB incidence declined by 21%, from 243 per lakh population in 2014 to 187 per lakh population in 2024. TB-related mortality fell by 28% during the same period.

Systematic tracking has also improved service delivery. Treatment coverage increased from 53% in 2015 to 92% in 2024, while the treatment success rate reached 90% in 2024.

Digital Monitoring and Community Support

The programme uses Ni-kshay, a national web-based ICT platform for TB surveillance, real-time tracking, case notification, and patient management. It acts as a unified repository for notifications from both public and private health sectors.

Pradhan Mantri TB Mukt Bharat Abhiyaan, launched in September 2022, promotes community-led support for TB patients. It enables Ni-kshay Mitras—including individual donors, corporate bodies, cooperative societies, and NGOs—to adopt patients and provide support such as nutritional baskets, diagnostic aid, and vocational assistance for at least six months.

Ni-kshay Poshan Yojana provides nutritional support through Direct Benefit Transfer. In October 2024, the monthly assistance was doubled from ₹500 to ₹1,000 for all registered TB patients during treatment.

The government also introduced Energy Dense Nutrition Supplementation under the scheme in October 2024. This targeted support is meant for TB patients with a Body Mass Index below 18.5 to address undernutrition-related treatment failures.

Diagnostic Advances and Treatment Changes

The NTEP has shifted from traditional sputum smear microscopy to advanced molecular tools such as the Cartridge Based Nucleic Acid Amplification Test and Truenat machines. These tests help detect TB and drug resistance earlier and more accurately.

In September 2024, the Ministry of Health and Family Welfare approved the nationwide rollout of the BPaLM oral regimen for drug-resistant TB. The regimen consists of Bedaquiline, Pretomanid, Linezolid and Moxifloxacin.

The BPaLM regimen replaced older injectable-based therapies that lasted 18–24 months. It reduced treatment duration to 26 weeks, or about 6 months, with an entirely oral course.

Key Prelims Takeaways

• Programme name: National TB Elimination Programme (NTEP), earlier called the Revised National Tuberculosis Control Programme.
• Administrative control: Central TB Division, Ministry of Health and Family Welfare.
• Scheme type: Centrally sponsored scheme under the National Health Mission.
• Strategic plan: National Strategic Plan for TB Elimination 2017–2025, based on Detect, Treat, Prevent and Build.
• Elimination benchmark: Less than one notified TB case per million population per year.
• Digital platform: Ni-kshay for TB notification, surveillance, and patient tracking.
• Nutritional support: Ni-kshay Poshan Yojana provides ₹1,000 per month through DBT for registered TB patients.
• Special supplementation: Energy Dense Nutrition Supplementation for patients with BMI below 18.5.
• Community initiative: Pradhan Mantri TB Mukt Bharat Abhiyaan and Ni-kshay Mitras support patients with nutrition and assistance.
• Drug-resistant TB regimen: BPaLM oral regimen with Bedaquiline, Pretomanid, Linezolid and Moxifloxacin.
• Treatment duration: BPaLM reduces treatment to 26 weeks.
• Funding pattern: 60:40 for general states, 90:10 for Northeastern and Himalayan states, and 100% for Union Territories.