Tuberculosis (TB), the world’s most lethal infectious disease, poses a major public health challenge in India, where millions are affected each year. Despite progress in diagnosis and treatment, TB continues to claim one life every minute which leads to serious social and economic challenges. To secure a solution and eradicate the disease, India has recently been looking to AI-driven tools.
India at the epicenter of the global TB crisis
India carries the heaviest TB burden in the world and accounted for 26% of global cases in 2023. The country reported 2.782 million new cases in 2023 out of 8.2 million new cases worldwide. According to the World Health Organization (WHO), despite a slight decrease, India remains responsible for one-third of global TB cases and deaths, highlighting the urgent need for more effective measures.
India fails to meet TB-free goal
In 2018, the country launched the TB-Free India campaign, aiming to eradicate the disease by 2025, an ambitious goal given that the WHO’s 2030 target is to reduce TB incidence by 80% and deaths by 90%.
However, progress has been hindered by insufficient funding and irregular supplies of essential medicines and diagnostic tools. Between 2017 and 2020, only 66% of the required funds were allocated, slowing down the fight against TB.
Encouraging progress
Despite these obstacles, India has made significant progress in decreasing the number of TB cases. From 2013 to 2023, the country has managed to reduce:
- TB incidence by 18%
- TB deaths by 21%
However, widespread underreporting, drug shortages and high antibiotic resistance are complicating the path to eradication.
Why is TB still a major threat?
1️⃣ Low awareness and late diagnosis
- More than 64% of symptomatic individuals do not seek medical care.
- Despite free government treatment, over 70% of patients opt for private hospitals due to understaffed and overburdened public facilities.
- Many private sector cases go unreported which hampers national tracking.
2️⃣ High prevalence of latent TB and malnutrition
- 40% of Indians are estimated to have latent TB which increases the risk of outbreaks.
- Malnutrition is linked to around 55% of annual TB cases.
3️⃣ TB on the rise among children, women hit worse
Children are more vulnerable to TB due to their developing immune systems. India reported 135,000 TB cases in children in 2022, 143,000 in 2023, and 141,000 in 2024.
The India TB Report 2023 states that although men are more likely to be affected by TB, women bear a heavier burden, often having limited access to nutrition, healthcare, and emotional support. Many are abandoned by their families, making their struggle even more challenging. Globally, 33% of women developed TB in 2022 while in India, the figure was 39.1%.
4️⃣ Drug-resistant TB
Antibiotic resistance has been escalating in India, with the country reporting 27% of the recorded drug-resistant TB cases worldwide. This means treatment takes longer, is more expensive and is less effective.
Frequent drug shortages are likely to have worsened the prevalence of TB. Between 2019 and 2024, India experienced three nationwide shortages of essential TB treatments.
5️⃣ Environmental and lifestyle factors
- Overcrowded spaces, homelessness and poor hygiene are known to facilitate the spread of TB.
- About 80% of TB cases in India are recorded among less well-off people.
- Tobacco use causes 7.9% of TB-related deaths. India is home to 253 million tobacco users, among the highest worldwide.
- India faces severe air pollution, resulting in 1.67 million deaths in 2019, and this significantly increases the risk of TB.
Robyn Waite, a TB advocate, compares the TB crisis in India with the AIDS crisis in South Africa in the 1990s when patients lacked drugs, communities were affected and government action was inadequate.
AI transforms TB detection
To prevent the spread of TB and improve early detection, India has recently been focusing on AI-driven tools and portable diagnosis devices. Last March, the Indian Council of Medical Research (ICMR) announced the validation of indigenous X-ray machines for community screening and these are already being used in 455 high-priority districts.
In addition, the ICMR has authorised the CyTb skin test developed by the Serum Institute of India which effectively detects latent TB infections, outperforming more expensive alternatives and offering a practical solution for areas with limited resources. DeepCXR, an AI-enabled chest X-ray interpretation system developed with the Institute of Plasma Research, is also expected to speed up the early detection and treatment of presumptive TB cases.
