Over the past few years, the entire world has become painfully aware of the devastating impacts that the COVID-19 pandemic has had on humanity. This virus has not spared the poor, the rich, or the middle class. With a population of more than one billion, Bharat (India) has faced a monumental challenge of dealing with the COVID-19 pandemic, while concurrently addressing numerous major societal and health burdens such as food insecurity, climate change, impoverishment, and the spread of other communicable diseases.
One issue of high concern in Bharat since the start of the COVID-19 pandemic has been regarding the potential for setbacks in tuberculosis control. Tuberculosis, or TB, is a deadly infectious disease that has persisted in Bharat for many years – likely, centuries. This disease comes in numerous, menacing forms, with the potential to have an impact on the lungs, but also the bones, the brain, and any other part of the body. To this today, it remains one of the deadliest infections on the planet, causing the death of more than a million people every year.
Due to all of this, many have predicted TB to rise during the COVID-19 pandemic, and to kill an increasing number of people as a result. Across a large number of countries in the world where TB is rampant, the reality is that this has been the case. In most of these countries, since the emergence of COVID-19, TB control efforts have been greatly impacted and death totals have risen.
However, our team’s recent study has shown that – against all odds, Bharat has instead shown a major decrease in TB deaths since the emergence of COVID. In our work, published in the medical journal Cureus, we compared TB data in Bharat from recent years to pre-pandemic levels. We demonstrated that there have been sharp decreases in the number of cases that have been detected – with the total new annual cases decreasing by nearly 25% in 2020 compared to 2019. Critically, across that same time period, there was also a major decrease in the total deaths by TB in Bharat.
In 2019, reported death totals of notified cases for TB were 89,823. In 2020, this decreased to a total of 76,002 deaths, signifying a 15.4% decrease during this time period. In this same period, at the national level there was an 18.8% decrease in TB deaths for patients treated in the public sector (69,843 deaths in 2019 and 56,705 deaths in 2020), and a 3.4% decrease in the private sector (19,980 deaths in 2019 and 19,297 deaths in 2020). Male death totals decreased by 22.6% (from 65,285 deaths in 2019 to 54,051 deaths in 2020), and female totals decreased by 10.4% (with 24,456 deaths in 2019 and 21,913 deaths in 2020).
Cite this article as: Varshney K, Patel H, Kamal S (2023) Trends in Tuberculosis Mortality Across India: Improvements Despite the COVID-19 Pandemic. Cureus 15(4): e38313. doi:10.7759/cureus.38313
This large scale public health success, with decreases in annual TB deaths, indicates that leadership in Bharat has been effective in fighting TB – especially considering that mortality totals have shown a trend in the opposite direction for many other countries. This has not been an accident; the government has made major efforts in strengthening TB control programs in ways that have concurrently curbed the spread of COVID, addressed poverty, and supported those in rural or other underserved areas. In many ways, this is an indication that Bharat is rising and advancing as a nation on many levels – even in a time when a multitude of other nations (including those far wealthier) are regressing on social and health measures.
The magnitude of this accomplishment has been so significant that the World Health Organization has recently even applauded leadership in Bharat for the work they have done. The director of the Global TB program in the World Health Organization, Dr. Tereza Kasaeva, has said many great things about Bharat’s control of TB during this difficult time, and that the country serves as a source of inspiration for nations across the globe that are fighting this deadly disease.
India bears the highest burden of TB in the world, however the country has demonstrated significant high level political commitment and action towards ending the disease…We applaud the leadership of the Honorable Prime Minister Narendra Modi in pursuing ambitious targets backed by a substantial increase in domestic funding, and implementation of innovative approaches and multisectoral actions to fast-track the TB response in the country. This provides inspiration to other countries and leaders to prioritise ending TB
Stated by Dr Tereza Kasaeva in: WHO applauds Indian leadership on ending TB. (2023).
While there is still an enormous amount of work needed to put an end to TB across Bharat, leadership has nonetheless shown that this deadly disease can be beaten and that many lives can be saved. There is certainly a long journey ahead, and during that journey, it is worthwhile to take some moments to celebrate this stellar achievement of Bharat on a global scale.
Jai Hind, Jai Bharat.
Karan Varshney, MPH, MD(c)
