Health Crisis in India: Tuberculosis on the Rise

In the suburban area of Govandi in Mumbai, relentless coughing can be heard among families living in cramped conditions under makeshift shelters. The narrow, waterlogged streets are stifling, hiding a lethal disease that invades homes almost unnoticed.

According to local doctors, tuberculosis (TB) has spread to nearly half of the households in this eastern urban enclave, inflicting grief as it claims lives and shatters families’ means of supporting themselves.

This local situation mirrors a nationwide health crisis, with India accounting for 27% of global TB cases. The World Health Organization (WHO) reports that a person dies from the disease every three minutes in the country.

The government has committed to eradicating TB by year’s end, but experts warn that this target is unrealistic, given the existing healthcare system gaps and socioeconomic challenges that hinder progress.

Mehboob Sheikh, now battling TB six months after his diagnosis, knows this struggle all too well. It has been more than ten years since he lost his wife to the same illness and, for him, the terror of this disease is painfully present.

“I’ve lost so much weight, I can barely walk, and I feel breathless when I speak,” he recounts, revealing how the disease has drained his strength.

TB has already cost him his job at a printing press; extended fatigue and weakness made it impossible to endure long shifts. He’s taken a nine-month course of antibiotics, but with just a few months left, his recovery seems distant.

Surrounded by his malnourished children, who seem too young to grasp the gravity of the situation, he struggles to manage their school fees after going from a monthly income of 15,000 rupees ($171) to barely getting by.

“If my body holds on, I will keep living. If not… that’s the end,” he reflects.

In 2018, Prime Minister Narendra Modi announced an ambitious plan to eliminate TB by 2025, five years ahead of the WHO’s global aim of reducing new cases and deaths significantly. However, as the deadline approaches, the reality is stark—TB remains one of India’s challenging public health battles.

The complexity of India’s TB crisis arises from a mix of biological factors, poverty, and deficiencies in the healthcare system. Dr. Lancelot Pinto, a lung expert based in Mumbai, states, “We are a high-burden nation and don’t have all the resources needed for a comprehensive TB elimination strategy.”

The bacteria responsible, Mycobacterium tuberculosis, has plagued humanity for centuries, lying dormant in some individuals for years and developing drug resistance, which complicates eradication efforts.

TB’s prevalence in densely populated, impoverished areas has left many without consistent access to healthcare.

Despite working in Govandi for a decade, health worker Pramila Pramod reports that the number of monthly TB patients she encounters has remained unchanged.

The crowded alleys provide a prime environment for disease transmission, and social stigma makes some patients reluctant to disclose their status even to loved ones.

“Sometimes, young women of marriageable age hide their TB diagnosis fearing it will ruin their chances for a suitable match,” Pramod shares.

The situation worsens due to systemic flaws, including years of underfunding in public healthcare, shortages of healthcare professionals, and outdated facilities. The private sector can be an option but is often costly and unregulated.

Many TB diagnoses rely on antiquated methods that can miss active cases. More precise molecular tests are used in only about one in four diagnoses. This contributes to untreated infections and the emergence of dangerous drug-resistant strains, according to experts like Pinto.

Case in point: 15-year-old Sufiya Syed suffered for over a year from symptoms before receiving a correct diagnosis just two months ago.

Her condition has drastically affected daily life—once able to attend school, she now finds it challenging to concentrate due to exhaustion and nausea.

“Each morning, I wake up feeling like I might faint. Sometimes, I go days without eating,” she confesses.

In response, the government is enhancing efforts by offering free TB testing and medications to reach vulnerable populations, with some noted progress. Since 2015, India has reduced its TB cases by 17.7%, nearly double the global average decrease.

However, significant hurdles remain, such as healthcare worker shortages and ineffective methods of identifying high-risk individuals. The COVID-19 pandemic further complicated matters by disrupting screenings and diverting essential health resources.

Diagnosing TB in remote communities is an uphill battle. Many people can’t reach clinics due to vast distances, and a chronic lack of specialists worsens the situation. USAID has previously provided over $140 million to support grassroots efforts, but recent U.S. funding cuts threaten these initiatives.

The Indian government is ramping up its approach, utilizing advanced tools like AI-powered X-rays, mobile testing vans, and drones. For example, a software designed by Qure.ai can analyze chest images rapidly, giving patients critical attention even in areas with a shortage of qualified radiologists.

These advancements are particularly crucial in India’s densely populated regions, where early detection is vital for controlling TB’s spread. New portable machines that run on batteries, making it feasible to screen entire communities in just one day, are increasingly being used.

This AI-enabled screening has now been integrated into India’s healthcare strategy, performing millions of X-rays across the nation. Even though data suggests improvement, for individuals like Sheikh, the struggle continues with little immediate relief.

He attends government hospital visits for treatment but notes that he’s yet to receive the cash assistance promised to TB patients, leaving him with an overwhelming sense of despair: “No one has come to help us. I have to support myself while I am alive.”