Tuberculosis (TB) remains a significant public health challenge in India, despite the country's ambitious goal to eliminate the disease by 2025, five years ahead of the global target. While India has made notable progress, there is a need to refine and intensify its approach further. A comprehensive strategy focusing on prevention, early and accurate diagnosis, and treatment adherence can significantly accelerate the elimination of TB. An insight by Saurabh Gupta - Head of Global Health, Mylan Discovery Solutions, Mylab
Strengthening Prevention: Identifying and Treating Latent TB
One of the most effective ways to curb TB is by addressing latent TB infection (LTBI). Many individuals infected with Mycobacterium tuberculosis do not exhibit symptoms initially, but they remain at risk of developing active TB later. Currently, India's focus has been primarily on treating active TB cases, but a more proactive approach is needed.
Testing for latent TB, particularly among high-risk groups such as household contacts of TB patients, healthcare workers, and immunocompromised individuals, should be prioritized. The Nikshay Mitra Scheme, which currently emphasizes nutritional support, can be expanded to encourage family-wide TB screening. This would allow for early detection and preventive treatment of LTBI cases, thereby reducing the reservoir of infection in the community.
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Many individuals infected with Mycobacterium tuberculosis do not exhibit symptoms initially, but they remain at risk of developing active TB later. Currently, India's focus has been primarily on treating active TB cases, but a more proactive approach is needed
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Expanding Access to Point-of-Care Testing
Early diagnosis is crucial for breaking the transmission chain of TB. Traditional TB diagnostic methods, such as sputum microscopy and culture tests, are time-consuming and not widely available at primary healthcare centres. To truly eliminate TB, point-of-care (POC) testing must become the norm.
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To truly eliminate TB, point-of-care (POC) testing must become the norm
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India should scale up the deployment of rapid molecular tests. POC testing allows for quicker diagnosis and initiation of treatment, thereby reducing the risk of further transmission. Additionally, mobile testing units can play a critical role in reaching remote and underserved populations, ensuring last-mile coverage.
Enhancing Multi-Drug Resistance (MDR) TB Detection
Drug-resistant TB is a major roadblock to elimination efforts. Multidrug-resistant TB (MDR-TB), particularly resistance to Rifampicin (RIF) and Isoniazid (INH), leads to prolonged treatment, higher costs, and increased mortality.
Routine drug susceptibility testing (DST) for RIF and INH should be mandated for all diagnosed TB cases rather than being restricted to high-risk patients. This will ensure the timely detection of resistance patterns and allow clinicians to prescribe the most effective treatment regimens from the outset.
Developing Predictive Models for At-Risk Populations
Identifying individuals at the highest risk of developing TB is essential for targeted interventions. Advanced predictive modelling using artificial intelligence (AI) and big data analytics can help stratify populations based on TB risk factors, such as malnutrition, diabetes, HIV co-infection, smoking, and overcrowded living conditions.
By integrating data from Nikshay (India’s TB tracking system) with AI-driven algorithms, public health officials can develop real-time risk maps, guiding focused interventions in high-burden districts. This predictive approach can help preempt outbreaks and prioritise resources for those most vulnerable.
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By integrating data from Nikshay (India’s TB tracking system) with AI-driven algorithms, public health officials can develop real-time risk maps, guiding focused interventions in high-burden districts
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A Multi-Pronged Approach for TB Elimination
India’s fight against TB requires an integrated, data-driven, and patient-centric approach. Expanding latent TB screening, promoting point-of-care diagnostics, strengthening MDR-TB detection, and leveraging AI-based predictive models can significantly accelerate progress toward elimination.
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Expanding latent TB screening, promoting point-of-care diagnostics, strengthening MDR-TB detection, and leveraging AI-based predictive models can significantly accelerate progress toward elimination
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The 2025 target is ambitious but achievable if India embraces innovation and strengthens its commitment to TB prevention, detection, and treatment. With the right strategies, India can set an example for the world in eradicating one of history’s deadliest infectious diseases.
