Context:
The 100 day intensified TB elimination campaign, which began on December 7, 2024, covered 33 States and Union Territories, with 455 intervention districts. It tried to find symptomatic and asymptomatic TB cases among high risk groups by way of chest X ray screening and bacteriological confirmation through molecular tests.
Key Highlights of the Campaign
Objectives
- Screening of vulnerable populations including diabetics, smokers, alcoholics, people living with HIV, past TB patients, elderly individuals, and household contacts of TB patients.
- Identification of subclinical/asymptomatic TB cases through AI assisted chest X ray screening.
- Case detection efforts are being genuinely expedited to reduce the time to diagnosis.
TB Notification Data
The increase in TB notifications compared to last year is slight(+220 cases). Increased notifications between Dec 7, 2024, and Feb 22, 2025, against same intervals of last year: +44,585 cases.
- These increments cannot be considered solely as the impact of the intensified campaign, because TB notifications have been hardly escalating for some years now:
- 2021: 21,35,830 cases
- 2022: 24,22,121 cases
- 2023: 25,37,235 cases
- 2024: 26,18,499 cases
Challenges and Limitations
Overclaim of Campaign Efficacy
- The government’s assumption that all 3.5 lakh cases in intervention districts were detected solely due to the campaign is dubious.
- The near statistics of total TB notifications across India only suggests that many of these cases would have been identified in the absence of the campaign.
Low Utilization of X Ray Screening
- Though the campaign claimed a new strategy to early detection using chest X rays, only 3.8 lakh of the 10 crore (100 million) people screened (3.8%) were reported to have undergone an X ray.
- The National TB Prevalence Survey (2019-2021) estimates that 42.6% of TB cases might have been missed without an X ray, thus making it a very useful tool.
- This was a further dampener on campaign efficacy: if not all the 3.8 lakh X ray screenings were meant for asymptomatic cases in the campaign, the campaign did not have other tools for intervention.
Poor Infrastructure
- Deployment was limited to 836 portable X ray vans across 455 districts, affecting coverage.
- Meanwhile, AI assisted chest X ray interpretation tools remain untested and unapproved by Health Technology Assessment (HTA).
Short Duration & Unrealistic Goal
- The 100-day campaign is too brief to achieve meaningful long-term TB reduction.
- Given India’s high TB burden, eliminating TB by 2025—as envisioned by Prime Minister Narendra Modi—appears overly ambitious without sustained and improved interventions.
While the 100-day intensified TB elimination campaign likely improved case detection to some extent, its overall impact has been overstated. Key limitations, including low X-ray screening coverage, inadequate infrastructure, and a short intervention period, undermine the effectiveness of the initiative.
Source: TH
