Tuberculosis (TB) Trends and Performance in India

Decline in TB Incidence and Mortality

• TB incidence in India fell below 200 per lakh population in 2022, compared to 237 per lakh in 2015, marking a 16% decline.
• TB mortality rate in 2022 was 23 per lakh population, reflecting an 18% decline compared to 2015.
• (Refer to Chart 1 for incidence trends and Chart 2 for mortality trends.)

Treatment Success Rates by TB Category

• Severely Drug-Resistant TB (resistant to isoniazid, rifampicin, any fluoroquinolone, and at least one second-line injectable drug):
  • Treatment success rate: 45% — the lowest among all TB types.
• MDR/RR-TB (Multidrug-resistant or rifampicin-resistant TB):
  • Treatment success rate: 74%.
• Pre-XDR-TB (MDR-TB with additional resistance to fluoroquinolones):
  • Treatment success rate: 68%.
• Encouragingly, treatment success rates are improving across categories (as shown in Chart 3).

State-Level TB Performance: TB Index

• Top-performing major States in TB control (Map 4):
  • Himachal Pradesh, Odisha, Gujarat.
• Bottom-performing major States:
  • Punjab, Bihar, Karnataka.

Catastrophic Health Expenditure in India

• Over 10% of India’s population faces catastrophic health expenditure, defined as spending more than 10% of household income on health costs.
• India ranks third highest in catastrophic health expenditure among 14 lower-middle-income countries with high TB burden.

Health Coverage vs. Out-of-Pocket Costs

• Approximately 60% of India’s population has health coverage, also ranking third-highest among similar economies.
• However, despite better insurance coverage, a large percentage of households still face steep health costs (Chart 5), indicating a gap between insurance penetration and financial protection.

TH