“Elimination of tuberculosis by 2025 is also targeted,” finance minister Arun Jaitley said during his February 1, 2017, budget speech as he spoke about eliminating Kala-Azar (black fever or Visceral leishmaniasis) and filariasis by 2017, leprosy by 2018 and measles by 2020.
The finance minister’s claim of eliminating tuberculosis (TB) by 2025 does not match targets for reduction of TB cases in the strategy document of India’s national tuberculosis control programme.
Eliminating the TB epidemic in India by 2025 would mean reducing new TB cases by 95% over the next decade. In comparison, India reduced TB cases by 22% between 2005 and 2015.
“To achieve these goals, we need to roll out new tools including more sensitive diagnosis, better prevention techniques like new vaccines or preventive medicines,” according to Soumya Swaminathan, director, Indian Council for Medical Research.
Checking the TB epidemic would mean reducing cases to less than 10 per 100,000 population. By 2025, the national TB programme (known as the Revised National Tuberculosis Control Programme) aims to reduce new TB cases to 44 per 100,000, down from 217 per 100,000 in 2015, according to the government’s strategic plan.
The government estimates that two million TB cases will be registered in 2025, according to the document.
The goal is to “achieve a rapid decline in burden of TB, morbidity and mortality while working towards elimination of TB in India by 2025”, according to the strategy document National Strategic Plan for TB Elimination 2017-2025.
India’s TB Control Programme “proposes bold strategies with commensurate resources to rapidly decline TB in the country by 2030 in line with the global End TB targets and sustainable development goal to attain the vision of a TB-free India”.
The WHO’s End TB strategy–to curb the TB epidemic, or its widespread occurrence–targets reducing new cases a year to under 10 per 100,000 people.
Further, the WHO defines elimination, or the near complete end of TB, as the reduction in the number of new TB cases in a year to less than 1 per million people.
In case of countries that have good reporting systems, the measure used is the number of TB cases reported to the government while the measure for other countries, like India, which have low reporting of TB cases, is the estimated number of new cases.
India currently has 27% of the world’s new TB cases, one of the biggest infectious disease killers in India. The country had 2.8 million new TB cases in 2015, and TB killed 480,000 in 2014, according to this 2016 WHO report. TB is a treatable air-borne disease but the treatment reaches only 59% patients in India, the report said.
In 2015, four countries/territories had 0 TB cases per 100,000 people–the British Virgin Islands, Bermuda, Monaco and Barbados–according to WHO data. The United Arab Emirates, Iceland and Puerto Rico had the lowest estimated TB incidence of 2 per 100,000.