India recorded about 2.7 million cases of tuberculosis in 2025. Based on population projections for that year, this translates to an incidence of about 185 cases per 100,000 population.

This is more than four times the TB elimination target for 2025, under the National Strategic Plan for Tuberculosis, set in March 2017. TB elimination means cases should be reduced to 44 cases per 100,000 population and mortality from TB to 3 per 100,000 population, as IndiaSpend reported in March 2025.

The 2025 target set by the government was five years ahead of the global End TB targets and United Nations’ Sustainable Development Goals. The latest update on progress, released yesterday, reverts to the SDG target.

Overall, India’s TB notification has increased by 13 percent since pre-Covid levels, data show.

Higher notification is not necessarily the outcome of increased incidence. Lack of testing accounts for the highest number of patients lost in the TB care cascade, and stigma keeps many patients from accessing tests, as IndiaSpend reported in July 2025. The government under the National Tuberculosis Elimination Programme (NTEP) has been pushing to boost the notification of cases, we had reported.

Researchers model the TB care cascade to estimate the gaps, as we explained in May 2023. The number of patients with incident TB who did not access TB tests constitute gap 1, patients who did not get diagnosed constitute gap 2, those who did not register for treatment constitute gap 3, those who were not successfully cured comprise gap 4, and those who relapsed or died even after being treated constitute gap 5.

Gaps represent patient losses--essentially, patients who fell through the TB care net. In this context, India’s most significant gap was gap 1, according to a 2019 study published in PLOS Medicine, that concluded that half of all patient losses in India are individuals with incident TB who didn’t access a TB test.

On World TB Day, as India pushes the elimination target back by five years, IndiaSpend spoke to patients, clinicians and researchers to understand how the target could be met.

India’s testing strategy under the TB-Mukt Bharat Abhiyan includes active casefinding—that is, screening communities with high risk of TB. When a patient reaches the health system with symptoms, or when vulnerable populations are screened through camps, the process begins with an X-ray to rule out active TB.

For all presumptive TB cases—that is, those with an abnormal X-ray or patients showing symptoms—the strategy requires 100 percent molecular testing using NAAT (rapid molecular tests that detect the genetic........

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