Tuberculosis in India: Comprehensive SWOC analysis

Tuberculosis (TB) is one of the major public health problems which has cursed humanity for centuries. 45 % of the global incidence of TB and 50% of global mortality due to TB is contributed by the World Health Organisation (WHO) South-East Asia (SEA) Region. India is the top contributor to TB burden in the world. In order to combat TB, India has developed and revised its health program regularly. India started its effort by launching the National Tuberculosis Control Programme (NTP) in 1962, which was gradually revised into the Revised National Tuberculosis Control Programme (RNTCP) in 1993 and now it is known as the National Tuberculosis Elimination Programme (NTEP) in 2020. In spite of the WHO's target of ending TB globally by 2035, the Indian government intends to accomplish this by 2025. NTEP's National Strategic Plan (NSP) 2017-2025 aims to eliminate TB, by focusing on reducing TB incidence, related deaths, and out-of-pocket expenditure. NSP 2017-2025 has four pillars: Detect, Treat, Prevent, and Build. These pillars emphasise the importance of early and accurate diagnosis of TB; treatment of TB; control and spread of TB infection; and focus on community participation. Unless the NSP's strengths are not strengthened further, weaknesses are not addressed, and opportunities and challenges are not fulfilled, the goal of eradicating tuberculosis will remain a pipe dream. Our review has focussed on the Strength - Weakness - Opportunities - Challenges (SWOC) of NTEP highlighting the efforts of the Indian Health System in combating TB.