Enhancing India's Health Security Efforts Against Mycobacterium Tuberculosis : Gaps and Opportunities.

Abstract

India bears a quarter of the world's tuberculosis (TB) burden. In 2018, the country set an ambitious goal to eliminate TB by 2025-5 years ahead of the global target. While India has launched several large-scale public health initiatives, including Pradhan Mantri TB Mukt Bharat Abhiyan and Ni-kshay Poshan Yojana, several challenges persist that threaten progress toward elimination. These include data transparency issues, overburdened healthcare systems, and an unrealistic timeline for achieving elimination. In this article, we highlight underaddressed health security challenges-including multidrug-resistant TB, weak biosafety infrastructure, relapse without posttreatment monitoring, environmental contributors like air pollution, and a lack of targeted strategies for tribal populations and undocumented immigrants-and call for a revised approach to TB elimination aligned with the global 2030 goal, emphasizing evidence-based policy, improved surveillance, workforce support, multisectoral coordination, and environmental and technological interventions.