New Campaign Against an Old Scourge, India’s 100-Day Anti-TB Drive Is a Welcome Step
Though India Missed Its 2025 TB Elimination Deadline, It Has Made Appreciable Strides. The Latest Campaign, Learning from Successes in Chhattisgarh and Puducherry, Focuses on High-Risk Areas, Timely Nutrition Support, and Improved Diagnostics
Eight years ago, the government announced its intent to eliminate tuberculosis in the country by 2025. Though India could not meet the deadline, it has taken appreciable strides in slowing the incidence of this bacterial disease. Today its healthcare system diagnoses more than 80 per cent of the estimated cases, a far cry from 2015 when close to 50 per cent of those infected by TB fell outside the radar.
However, the disease continues to present a formidable challenge. Close to a lakh cases go undetected in the country, and chances of the infection spreading remain high. That is why the Centre’s 100-day campaign against TB, which began on Tuesday, is a step in the right direction. Public health programmes against difficult contagious diseases require periodic bursts of urgency focused on high-risk areas, because national figures can often mask deeply localised epidemics.
The Challenge That Remains
Tuberculosis is one of the oldest scourges known to humanity, and India has the dubious distinction of bearing the highest burden of the disease in the world. For decades, the response was fragmented, underfunded, and inadequate. The announcement of the 2025 elimination target was a declaration of intent—a recognition that business as usual would not be enough.
The progress since then has been real. Diagnostic coverage has expanded dramatically. Treatment regimens have improved. Public awareness has increased. But the disease is resilient. It thrives in conditions of poverty, overcrowding, and malnutrition—conditions that still characterise the lives of millions of Indians. And it has evolved, with multidrug-resistant strains posing a new and formidable threat.
The 100-day campaign is an acknowledgment that the fight against TB cannot be fought with routine measures alone. It requires bursts of concentrated effort, targeted at the areas where the disease is most entrenched, supported by the resources and political will that routine programmes often lack.
Learning from Chhattisgarh
Chhattisgarh’s 100-day anti-TB project recognised this imperative—it eliminated the disease in more than 4,000 gram panchayats between December 2024 and March 2025. This is not a small achievement. Chhattisgarh is a state with significant tribal populations, areas of high poverty, and historical underinvestment in healthcare infrastructure. If TB could be eliminated in thousands of villages there, it can be eliminated elsewhere.
What made the difference? The state’s success was not accidental. It was the result of a focused, time-bound campaign that deployed resources intensively, engaged local communities, and—crucially—ensured that patients received the nutritional support they needed to complete their treatment.
TB is not just an infectious disease; it is a disease of poverty. Malnutrition weakens the immune system, making people more susceptible to infection. It also makes treatment more difficult, because the body needs adequate nutrition to recover. For decades, TB programmes focused on diagnosis and medication while ignoring the nutritional needs of patients. The result was high rates of treatment abandonment and poor outcomes.
Chhattisgarh’s campaign prioritised nutrition. By ensuring that patients received timely cash transfers for food, the state improved treatment adherence and outcomes. The lesson is simple but powerful: treating TB requires treating the whole person, not just the bacteria.
The Nutrition Gap
The government has also pushed for expediting its Rs 1,000 monetary support for nutrition to TB patients. The thrust on timely payments is a recognition of one of the shortcomings of the anti-TB programme. Reports have shown that delays in processing the payment have rendered the nutritional support ineffective in several parts of the country.
In contrast, the success of the anti-TB programme in Chhattisgarh and Puducherry owes much to timely cash transfers to the undernourished. When patients receive money when they need it, they can buy the food they need to support their recovery. When payments are delayed, the support is meaningless.
The 100-day campaign must prioritise this aspect. It is not enough to allocate funds; the funds must reach patients quickly and efficiently. This requires administrative systems that work, digital infrastructure that connects beneficiaries to payments, and accountability mechanisms that ensure delays are addressed.
The Focus on High-Risk Areas
Over the next 100 days, healthcare workers will screen those living in 1.58 lakh villages. They will also reach out to vulnerable people such as those living with HIV, diabetes and residents of high-density areas.
This targeting is essential. TB is not evenly distributed across the country. It clusters in areas of poverty, in urban slums, in tribal regions, in places where healthcare access is limited. National figures can create a false sense of progress, because they average out the successes in better-off areas with the failures in worse-off ones. The 100-day campaign cuts through this averaging by focusing directly on the places where the disease is most entrenched.
The choice of villages as the unit of intervention is also significant. India’s healthcare system is structured around villages, with ASHA workers and auxiliary nurse midwives providing the frontline of primary care. By focusing on villages, the campaign leverages existing infrastructure and personnel. It is not creating new structures but strengthening existing ones.
The Multidrug-Resistant Threat
The government would do well to treat its latest drive as a catalyst for improved diagnostics, regular follow-ups and better community engagement. Institutionalising the learnings of the 100-day campaign could go a long way in addressing the most difficult TB-related challenge—the disease’s multidrug-resistant version.
This virulent form of TB occurs largely because of the mismanagement of the disease. When patients do not complete their treatment, when they take incorrect dosages, when they drop out of therapy mid-course, the bacteria that survive become resistant to the drugs that were meant to kill them. These resistant strains can then be transmitted to others, creating a new wave of infection that is harder and more expensive to treat.
Multidrug-resistant TB is a crisis within a crisis. It requires longer treatment regimens, more expensive drugs, and more intensive monitoring. It is also more likely to be fatal. The 100-day campaign must lay the groundwork for better management of the disease to prevent the emergence of resistance.
The Patient’s Burden
TB care is exacting for patients as well as caregivers. A standard course of treatment lasts six months, during which patients must take multiple pills every day. Side effects can be severe. The need to travel to healthcare facilities, the loss of income, the stigma associated with the disease—all of these factors contribute to treatment abandonment.
This is why patients continue to drop therapy mid-course or do not take the correct dosage. It is not because they do not want to get better. It is because the demands of treatment, combined with the realities of poverty, make adherence difficult.
The 100-day anti-TB campaign needs to lay the ground for improved support systems. This means more than just nutritional support. It means patient-centred care that takes into account the realities of patients’ lives. It means home-based treatment options that reduce the need for travel. It means support groups and counselling that help patients cope with side effects and stigma. It means addressing the social determinants of the disease—poverty, overcrowding, malnutrition—that make people susceptible in the first place.
The Role of Community Engagement
One of the successes of India’s TB programme has been the engagement of community health workers. ASHAs have been crucial in case finding, treatment support, and follow-up. The 100-day campaign must build on this foundation, ensuring that community health workers have the training, resources, and support they need to do their jobs effectively.
But community engagement goes beyond health workers. It means involving local leaders, religious institutions, schools, and employers in the fight against TB. It means reducing stigma so that people are willing to come forward for testing and treatment. It means creating an environment where adherence to treatment is supported rather than stigmatised.
Institutionalising Success
The 100-day campaign is a sprint, but the fight against TB is a marathon. The real challenge will be to institutionalise the learnings from the campaign—to take the innovations and successes of the next 100 days and make them part of routine practice.
This is not automatic. Campaigns often generate energy and momentum that dissipate once the campaign ends. To prevent this, there must be a plan for sustainability from the outset. What systems are being put in place that will outlast the campaign? What training is being provided that will continue to benefit health workers? What data is being collected that will inform future policy?
The government must also address the broader determinants of TB. The disease is a marker of poverty. As long as millions of Indians live in overcrowded conditions, without adequate nutrition, with limited access to healthcare, TB will continue to thrive. The 100-day campaign is necessary, but it is not sufficient. It must be accompanied by sustained efforts to improve living conditions, reduce poverty, and strengthen the healthcare system.
Conclusion: A Step Forward
The Centre’s 100-day campaign against TB is a welcome step. It builds on the successes of state-level initiatives, focuses on high-risk areas, and recognises the importance of nutrition support. It brings urgency to a fight that requires it.
But it is only a step. The goal of eliminating TB by 2025 was missed, but the goal remains. To achieve it, India must sustain the momentum of this campaign, institutionalise its learnings, and address the deeper determinants of the disease. The 100 days will pass. What happens after will determine whether this campaign was a fleeting moment or a turning point.
Q&A: Unpacking India’s 100-Day Anti-TB Campaign
Q1: What is the significance of India’s 100-day anti-TB campaign?
A: The campaign, which began on March 25, 2026, focuses on high-risk areas with periodic bursts of urgency, because national TB figures can mask deeply localised epidemics. Over 100 days, healthcare workers will screen 1.58 lakh villages and reach out to vulnerable populations such as those living with HIV, diabetes, and residents of high-density areas. The campaign also prioritises timely Rs 1,000 nutritional support payments, addressing a key shortcoming in the anti-TB programme.
Q2: What progress has India made against TB since the 2025 elimination target was set?
A: Though India missed the 2025 elimination deadline, it has made appreciable strides. Today, the healthcare system diagnoses more than 80 per cent of estimated TB cases—a significant improvement from 2015 when close to 50 per cent of infected individuals were undiagnosed. However, close to a lakh cases still go undetected annually, and the disease remains a formidable challenge.
Q3: What lessons have been learned from Chhattisgarh’s 100-day anti-TB project?
A: Chhattisgarh eliminated TB in more than 4,000 gram panchayats between December 2024 and March 2025. Key to its success was timely cash transfers for nutritional support, which improved treatment adherence and outcomes. The state’s experience demonstrates that focused, time-bound campaigns with adequate nutritional support can achieve significant results even in areas with high poverty and limited infrastructure.
Q4: Why is timely nutritional support critical for TB treatment?
A: TB is a disease of poverty, and malnutrition weakens the immune system, making people more susceptible to infection and harder to treat. Patients need adequate nutrition to recover. Reports have shown that delays in processing the Rs 1,000 nutritional support payment have rendered it ineffective in several parts of the country. In contrast, timely cash transfers in Chhattisgarh and Puducherry contributed significantly to their success. The 100-day campaign prioritises expediting these payments.
Q5: What is the multidrug-resistant TB threat, and how does the campaign address it?
A: Multidrug-resistant TB occurs largely due to mismanagement of the disease—when patients drop out of therapy mid-course or do not take correct dosages, the surviving bacteria become resistant to drugs. This virulent form is harder and more expensive to treat. The 100-day campaign aims to lay the ground for improved support systems, including better diagnostics, regular follow-ups, and enhanced community engagement, which are essential to preventing the emergence and spread of drug-resistant strains.
