TB Elimination in India – Progress, Strategies and Challenges

Why in News?

Recently, World Tuberculosis Day was Observed annually on March 24 as, the day commemorates Robert Koch’s discovery of the tuberculosis-causing bacterium in 1882.

What are the trends in TB reduction in India?

• Decline in TB incidence (new cases) – India’s TB incidence has fallen by ~21% between 2015 and 2024.
• This decline is almost double the global average (~12%).
• Incidence rate improved to about 187 cases per 100,000 population (2024).
• Decline in TB mortality (deaths) – Mortality dropped from 28 → 21 deaths per 100,000 (2015–2024).
• This reflects better treatment access and earlier diagnosis.
• Big improvement in detection & treatment coverage – Treatment coverage increased from ~53% (2015) → >92% (2024).
• “Missing cases” reduced dramatically (from ~15 lakh to <1 lakh).
• Massive screening campaigns (hundreds of millions screened).
• Mixed trend in drug-resistant TB – Overall multidrug-resistant TB (MDR-TB) is gradually declining.
  • For Example, 28% decline in MDR-TB cases in Mumbai (2022–2025), but regional increases still occur (e.g., Uttar Pradesh).
• Post-COVID disruption and recovery – TB control was disrupted during COVID-19 (2020–2022)
• This caused:
  • Missed diagnoses
  • Temporary rise in transmission
• Since 2023–2024, detection and incidence trends are improving again
• High burden – India still has the highest TB burden globally
• India accounts for ~25% of global TB cases

What is the nature and transmission tuberculosis?

• Causative agent – Tuberculosis is caused by the bacterium Mycobacterium tuberculosis, primarily affecting the lungs but also capable of impacting other organs such as the brain, kidneys, and spine.
• 2 forms – The disease exists in two forms: latent and active TB.
  • While latent TB remains non-infectious, it can progress to active TB, especially among individuals with weakened immunity.
• Transmission – the transmission of the diseases occurs through airborne droplets when an infected person coughs, sneezes, or speaks.
• However, TB does not spread through casual contact such as handshakes, sharing food, or using public facilities.
• Medical interventions – Early diagnosis and sustained treatment are critical, as untreated TB can be fatal.
• Importantly, patients generally become non-infectious after two weeks of appropriate treatment, underscoring the importance of timely medical intervention.

What is the National Plan of India to End TB?

• National Strategic Plan (NSP) 2020–25 – India’s commitment to eliminating TB is reflected in its National Strategic Plan (NSP) 2020–25, which is aligned with the Sustainable Development Goals.
• 4 pillars – The plan is structured around four pillars: Detect, Treat, Prevent, and Build.
  • Detect focuses on early and accurate diagnosis using advanced tools.
  • Treat emphasizes prompt, quality-assured treatment, including for drug-resistant TB.
  • Prevent involves contact tracing and preventive therapy among high-risk groups.
  • Build aims at strengthening health systems and addressing social determinants.
• This integrated approach ensures that TB control is not merely a medical intervention but a comprehensive public health mission.
• National TB Elimination Programme – The National TB Elimination Programme (NTEP), formerly known as RNTCP, serves as the backbone of India’s TB control efforts.
• It incorporates modern diagnostics, free treatment services, and patient-centric support systems.
• Key features of NTEP include:
  • Early diagnosis through high-quality molecular testing and community outreach
  • Free and standardized treatment for all TB patients
  • Integration with the private healthcare sector
  • Nutritional and financial support via direct benefit transfers
  • Contact tracing and preventive treatment for vulnerable populations
  • Multi-sectoral coordination to address socio-economic determinants
• The programme represents a paradigm shift from disease control to disease elimination.
• TB Mukt Bharat Abhiyaan – The Pradhan Mantri TB Mukt Bharat Abhiyaan, launched in 2022, has transformed TB elimination into a mass movement or Jan Andolan.
• It seeks to mobilize individuals, communities, corporates, and civil society to support TB patients and strengthen public health efforts.
• Under this initiative:
  • Over 20 crore individuals have been screened for TB
  • More than 28 lakh cases have been detected, including asymptomatic individuals
  • 46,118 Gram Panchayats have achieved TB-free certification
  • Treatment success rates have reached 90%, exceeding the global average
• The campaign demonstrates the power of community engagement in addressing public health challenges.
• Nutrition and Care – Recognizing that TB is closely linked to malnutrition and poverty, the government has implemented targeted welfare schemes.
• The Nikshay Poshan Yojana provides ₹1,000 per month to TB patients to ensure adequate nutrition during treatment.
• Since its inception, thousands of crores have been disbursed to beneficiaries.
• Complementing this is the Ni-kshay Mitra initiative, where volunteers provide food baskets, psychosocial support, and vocational assistance.
• This approach addresses not only the medical but also the socio-economic dimensions of TB, improving treatment adherence and outcomes.
• 100-Day TB Mukt Bharat Abhiyaan – To accelerate progress, the government launched a 100-day intensive campaign in high-burden districts in December 2024.
• This initiative focused on vulnerability mapping and active case finding.
• The results have been significant:
  • Screening of over 20 crore people
  • Detection of 9 lakh asymptomatic cases
  • Enhanced awareness and community participation
• By identifying hidden cases, the campaign has helped break the chain of transmission, a critical step toward elimination.
• Medical Innovation – A major breakthrough in TB treatment is the introduction of the BPaLM regimen, comprising Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin.
• This regimen is particularly effective for drug-resistant TB and has the following  advantages:
  • Reduction of treatment duration to 6 months
  • Improved safety and efficacy
  • Better patient compliance
  • The adoption of such advanced treatment protocols reflects India’s commitment to incorporating global best practices.
• Strengthening Healthcare Infrastructure – India’s TB elimination efforts are supported by a vast healthcare network, including Ayushman Bharat’s Ayushman Arogya Mandirs.
• With over 1.84 lakh centres, these facilities provide accessible and affordable diagnostic and treatment services.
• Additionally, the country has established:
  • Over 9,800 rapid molecular testing centres
  • 107 advanced laboratories for drug susceptibility testing
  • This infrastructure ensures early detection and timely intervention, even in remote areas.
• Leveraging Technology – India is at the forefront of integrating artificial intelligence into public health.
• AI-based tools are being used for screening, diagnosis, and treatment monitoring.
• Key innovations include:
  • Acoustic AI for cough analysis to detect TB signatures
  • Radiology AI for automated interpretation of chest X-rays
  • Predictive analytics to identify high-risk patients and prevent treatment failure
• These technologies have improved detection rates and reduced adverse outcomes, demonstrating the transformative potential of digital health solutions.
• Inclusive Healthcare Delivery – Efforts to eliminate TB extend to geographically isolated and underserved regions.
  • For instance, intensive screening campaigns in remote areas such as the Gurez Valley in Jammu and Kashmir have utilized mobile diagnostic units and portable X-ray machines.
• Such initiatives highlight the government’s commitment to ensuring equitable healthcare access, regardless of geographical barriers.

What are the Challenges?

• Persistent challenges – Despite significant progress, several challenges remain:
  • A large reservoir of latent TB infections
  • Rising cases of drug-resistant TB
  • Socio-economic factors such as poverty, malnutrition, and overcrowding
  • Gaps in awareness and stigma associated with the disease
• Addressing these challenges requires sustained political commitment, increased investment in healthcare, and continued community participation.

What lies ahead?

• India’s journey towards TB elimination represents one of the most ambitious public health missions in the world.
• Through a combination of strategic planning, technological innovation, community engagement, and social support, the country has achieved substantial progress in reducing TB incidence and mortality.
• However, the goal of eliminating TB by 2025 demands sustained efforts and vigilance. Strengthening healthcare systems, addressing social determinants, and leveraging emerging technologies will be crucial in maintaining momentum.
• If current trends continue, India has the potential not only to meet its target but also to serve as a global model in the fight against tuberculosis.

Reference

PIB| TB Elimination Programme Of India

Cooperative in India

Why in News?

Alongside support from the Government of India, state governments also provide financial assistance—such as grants and subsidies—to cooperatives through their own schemes, in line with state-specific rules and regulations.

What are Cooperatives?

• Cooperative – It is an autonomous association of persons, united voluntarily to meet their common economic, social, and cultural needs and aspirations through a jointly owned and democratically member-controlled enterprise.
• Principle – Founded on principles of self-help & mutual assistance,
• Aim – To serve the interests of disadvantaged sections of society rather than to generate profits.
• Coverage – They plays a major role in India’s economy, with 98% coverage in rural India, cooperatives are the mainstay of rural economy ensuring sustainable livelihoods and income for people.
• Diverse Sectors – Cooperative societies in India operate across various sectors such as Agriculture, Credit and Banking, Housing, and Women’s Welfare.

Cooperatives is a State subject under the Constitution of India.

What is the historical evolution of cooperatives in India?

• Pre-Independence Era
  • 1904: Cooperative Credit Societies Act – first legal framework.
  • 1912: Expanded scope to marketing and artisan societies.
  • 1914: Maclagan Committee proposed a 3-tier cooperative banking system.
  • 1925: Bombay Cooperative Society Act – provincial legislation.
  • 1942: Multi-Unit Cooperative Societies Act for cross-province cooperatives.
• Post-Independence Era
  • Cooperatives integrated into Five-Year Plans for rural development.
  • 1963: National Cooperative Development Corporation (NCDC) established.
  • 1982: NABARD created to support rural credit.
  • 1984: Multi-State Cooperative Organisations Act streamlined governance.
  • 2002: National Policy on Cooperatives harmonized legal frameworks.
  • 2023: MSCS Amendment Act strengthened transparency and governance.
  • 2025: National Cooperation Policy

What are the constitutional & legal framework for cooperative societies in India?

• Seventh schedule
  • Entry 44 of the List I - Union List for objects not confined to one State.
  • Entry 32 of the List II - State List for objects confined to one State.
• Fundamental Rights – Article 19(1)(c) deals with the right to form cooperative societies.
• Directive Principles of State Policy – Article 43B mentions about state policy for promotion of cooperatives.
• Part IX B – Introduced Articles 243ZH to 243ZT for incorporation, regulation, and winding up of cooperatives.

Article 19(1) (c), Article 43B, part IX B were added in Constitution by 97th constitutional amendment act, 2011.

• Cooperative Societies Act, 1912 – The first comprehensive law for cooperative societies in India.
• State Cooperatives – Societies operating within one state are regulated by state-specific Cooperative Societies Acts, overseen by State Registrars.
• Multi-State Cooperatives – Societies operating in more than one state are governed by the Multi-State Co-operative Societies Act, 2002, overseen by the Central Registrar.
• Cooperative Banks – While registered under state or central laws, they are regulated by the RBI under the Banking Regulation Act, 1949, with supervision from NABARD.
• Nodal Ministry – The central Ministry of Cooperation, established in 2021, provides policy oversight.

What is the Structure of Cooperatives in India?

Credit vs Non-Credit Cooperatives 

• Cooperative Credit Society – It provides financial assistance to members by accepting deposits and granting loans at reasonable interest rates.
  • Examples include Village Service Cooperative Society and Urban Cooperative Banks.
• Non-Credit Cooperatives – It provides goods/services like farming inputs, housing, etc. Examples includes
  • Consumers’ Cooperative Society - Formed to provide consumer goods at reasonable prices, eliminating middlemen by purchasing directly from producers. Eg. Kendriya Bhandar & Apna Bazar.
  • Producers’ Cooperative Society - Supports small producers by providing necessary production items such as raw materials and equipment. Eg. APPCO & Haryana Handloom.
  • Cooperative Marketing Society - Assists small producers in marketing their products by collectively selling on their behalf. Eg. Gujarat Cooperative Milk Marketing Federation (AMUL).
  • Cooperative Farming Society - Small farmers form these societies to gain benefits of large-scale farming. Eg. Lift-irrigation cooperatives & pani-panchayats.
  • Housing Cooperative Society - Offers affordable residential options by purchasing and developing land for members. Eg. Employees’ Housing Societies and Metropolitan Housing Cooperative Society.

What are the significance of Cooperatives in India?

• Scale & Reach – India is home to over 8.44 lakh cooperatives, including 2 lakh credit cooperatives & 6 lakh non-credit cooperatives across housing, dairy, fisheries, and more.

India has more than one-fourth of the world's cooperatives.

• Housing cooperatives – Approximately, 1.92 lakh societies, expanding in both rural and urban areas.
• AMUL – The benchmark success story, inspiring replication across sectors.
• Grain Storage Plan – India aiming for the world’s largest cooperative grain storage infrastructure, with warehouses at PACS and society level.
• "Sahkar se Samriddhi" (Prosperity through Cooperation) Model – The government is fostering these institutions to turn small, disjointed farmers into empowered economic units through modernized, digitally enhanced cooperatives (like the focus on enhancing 100,000 PACS).
• Empowerment of Women & Small Producers – Cooperatives allow small producers to combine resources, enhancing bargaining power.
• They act as a key to empowering women through local, self-reliant economic organizations.

What are the challenges faced by cooperatives in India?

• Governance issues – Lack of professional expertise leads to inefficiency, weak financial oversight, and occasional fraud or corruption.
• Political Interference – Excessive state control in elections and decision‑making undermines autonomy and democratic functioning.
• Financial Limitations – Rural cooperatives often suffer from inadequate capital and restricted access to funds, limiting growth and diversification.
• Member Participation & Awareness – Low awareness of cooperative benefits results in poor participation and weak representation of marginalized groups.
• Infrastructure & Technology Gaps – The outdated facilities and slow adoption of modern technology reduce efficiency and outreach.
• Regulatory & Legal Complexities – The Urban cooperative banks face dual regulation (Registrar & RBI), while constitutional debates around the 97th Amendment create uncertainty over Union vs. State powers.
• Financial Distress – Having high levels of NPAs in urban cooperative banks erode trust and threaten long‑term sustainability.

What are the recent initiatives taken by the government to improve the cooperatives in India?

• National Cooperative policy, 2025 – Recently formulated by the Government, which marks a strategic roadmap for revitalizing India’s cooperative sector to meet the nation’s goal of becoming “Viksit” by 2047.
• UN International Year of Cooperatives – The year 2025 was declared as the International Year of Cooperatives.
• Union Budget 2025–26 – Ministry of Cooperation has allocated with Rs.1,186.29 crore, to emphasis on digitization, training, institutional support.
• MSCS Amendment Act, 2023 – To strengthen governance, enhance transparency, increase accountability and reform electoral process, etc. in the Multi State Cooperative Societies.
• Tax benefits to cooperative societies – Benefit from reduced surcharge rates and concessional tax regimes, enhancing cooperative’s income and supporting rural and farming communities.
• Digital & Infrastructure Initiatives
  • Computerization of PACS - Over 15,000 societies onboarded (aims to computerize 63,000 PACS).
  • PACS as Common Service Centers (CSCs) – An MoU with MeitY and NABARD enables 30,647 PACS to offer 300+ e-services to rural citizens.
  • Diversification – PACS running petrol/diesel outlets, PM Jan Aushadhi Kendras, and PMKSK fertilizer services.

What lies ahead?

• Revitalizing cooperatives demands a comprehensive strategy that strengthens both their operational capacity and structural framework.
• Such an approach aligns with the goals of inclusive development and has the potential to uplift marginalized communities in India, echoing Gandhian ideals of self‑reliance and self‑governance.
• Building a large and robust cooperative ecosystem can firmly establish the belief that cooperation can be a vital instrument for the country’s development for future generations.
• The role of the cooperative sector can be strengthened in achieving the goal of 'Viksit Bharat 2047.

References

1. PIB | Grants To Cooperative Institutions
2. PIB | National Cooperation Policy 2025

Strategic Petroleum Reserves in India

Why in News?

India’s strategic petroleum reserves (SPRs), which have a capacity to store 5.33 million tonnes of crude oil, are currently holding 3.37 million tonnes of oil, or just about 2/3 of their total storage capacity.

• Strategic Petroleum Reserves (SPRs) – These are massive, government-controlled stockpiles of crude oil stored in underground rock caverns.
• Aim - It is designed to safeguard a nation against severe supply disruptions caused by geopolitical, natural, or economic disasters.
• They act as an emergency insurance policy, allowing countries to maintain energy security during crises.
• Origin - The concept of dedicated strategic reserves was first mooted in 1973, after the first oil crisis.
• Western strategic reserves have been tapped during the first Gulf War (1991), after Hurricane Katrina (2005), and in 2022 after global oil prices surged in the wake of Russia’s invasion of Ukraine.
• Highest SPR Holding Countries - Countries like the US, China, and Japan maintain massive strategic petroleum reserves.
• SPRs in India - The SPRs spread across 3 locations Visakhapatnam (Andhra Pradesh), Mangaluru, and Padur (Karnataka) are meant to act as a buffer for short-term supply shocks.
• At full capacity, the 3 SPRs cover around 9.5 days of India’s crude oil supplies.
• Quantity of the crude available in the caverns varies depending on market conditions.
• In 2021, the government had approved the establishment of 2 more commercial-cum-strategic petroleum reserves with
  • A cumulative storage capacity of 6.5 million tonnes to 4 million tonnes in Odisha’s Chandikhol and
  • Another 2.5 million tonnes in Karnataka’s Padur.
• Besides these, there were plans to have reserves in places like Bikaner and Rajkot, which would have raised the total SPR capacity by another 6 million tonnes.
• Decisions on these reserves are yet to be taken.

India is the world’s 3^rd-largest consumer of crude oil and depends on imports to meet over 88% of its requirement.

• IEA Recommendation - The IEA recommends that countries should hold oil stocks equivalent to at least 90 days of their net oil imports.
• IEA members are obligated to maintain these levels of reserves; India is not a full member of the grouping but an associate member.
• India’s total oil and fuel stockpiles - India doesn’t hold the 90-day strategic reserves, as well as commercial inventories.
• The current total national capacity for storage of crude oil and petroleum products is 74 days, including commercial stocks with refiners; it is still lower than what the IEA recommends.
• The actual reserve is a dynamic number depending on the stocks and actual consumption, both of which are not static.
• In view of the disruption in oil supplies from West Asia recently, India had enough crude oil and fuel stocks to meet up to 8 weeks of the country’s requirement.
• With oil from non-West Asia regions continuing to come and Indian refiners ramping up imports from alternative sources like Russia, the volumes are expected to have risen further.

Reference

The Indian Express | India’s strategic petroleum reserves

World Tuberculosis Day

Why in News?

World Tuberculosis Day observed across the globe recently.

• Tuberculosis (TB) – It is a serious infectious disease caused by the bacterium Mycobacterium tuberculosis.
• Types of TB
  • Active TB - The bacteria are multiplying, causing symptoms (fever, night sweats, weight loss, cough, chest pain), and can be spread to others.
  • Latent TB (Inactive) - The bacteria live in the body but are controlled by the immune system.
  • People with latent TB are not sick, do not have symptoms, and cannot spread the disease, though they may develop active TB later.
• Symptoms - Persistent cough (sometimes with blood), chest pain, fatigue, weight loss, and fever/night sweats.
• Transmission - Spread through the air when a person with active lung/throat TB coughs, speaks, or sings. It is not spread by sharing food, shaking hands, or touching surfaces.
• Risk Factors - People with weak immune systems, such as those living with HIV, are at higher risk of developing active TB.
• Treatment - Active TB is treated with a combination of antibiotics for at least 6to nine months. Latent TB can also be treated to prevent it from becoming active.
• TB is preventable and curable, yet remains one of the deadliest infectious diseases.

India accounts for approximately 27% of global TB cases.

India’s TB Elimination Efforts

• TB Mukt Bharat Abhiyan - National campaign to eliminate TB by 2025.
• Nikshay Portal- Digital platform for TB patient management and monitoring.
• Nikshay Poshan Yojana - Nutritional support scheme providing Rs.500/month to TB patients.
• Private Sector Engagement- Mandatory notification of TB cases by private practitioners.
• Community Participation - Awareness drives, door-to-door screening, and treatment adherence programs.
• Research & Innovation - Adoption of new diagnostic tools and shorter drug regimens.
• Challenge - Drug-resistant TB is a growing challenge requiring stronger innovation and adherence strategies.

Global efforts in tuberculosis (TB) diagnosis and treatment have saved an estimated 83 million lives since 2000.

References

1. PIB | World Tuberculosis Day
2. WHO | World Tuberculosis Day

National Mission on Monuments and Antiquities (NMMA)

Why in News?

The National Mission on Monuments and Antiquities (NMMA) has successfully documented 1.84 lakh monuments (Built Heritage & Sites) and 17.20 lakh antiquities across India.

• Aim - To prepare two national registers for documentation and digitization of unprotected monuments (Built Heritage & Sites) and antiquities across India.
• To ensure standardized, accurate, and accessible records of India’s cultural heritage.
• Established in –2007 under the 11^th Five-Year Plan.
• Nodal Ministry – Ministry of Culture.
• Implementing Agency – Archaeological Survey of India.
• Core Objectives - Documentation of unprotected monuments and antiquities.
• Digitization of records for public access.
• Establishment of uniform formats (20 parameters for monuments, 21 for antiquities).
• Capacity building through workshops and training programs for universities, colleges, NGOs, and other organizations.
• Awareness generation about heritage conservation and documentation.
• Using documentation as a landmark step against the illicit trafficking of Indian antiquities.
• Categorization of Documented Antiquities
• The database includes a wide array of man-made materials, such as
  • Ancient Tools- Palaeoliths, microliths, and neoliths.
  • Artistic Objects- Sculptures, terracotta, paintings, and textiles.
  • Historical Records- Inscriptions, seals, sealings, coins, and coin moulds.
  • Diverse Materials- Items made of metal, stone, glass, wood, ivory, and bone.
• Progress and Achievements - Documented 1.84 lakh monuments (Built Heritage & Sites).
• Documented 17.20 lakh antiquities.
• Related Initiatives - Indian Heritage Mobile App – Launched in September 2023 this serves as a single access platform for high-resolution images and geo-tagged locations of protected national monuments.
• Adopt A Heritage (AAH) 2.0 –Launched in 2026 to engage private and public sector companies to provide non conservational amenities like cleaning drinking water and signage at protected sites.
• Retrieval of Antiquities – As of late 2025 the ASI has successfully retrieved 655 antiquities from foreign countries since 1976.
• Aligns with - India’s obligations under UNESCO conventions on cultural heritage.

References

1. PIB | NMMA
2. NMMA | NMMA

Archaeological Survey of India (ASI)

Why in News?

Digitisation of historical/religious sites and antiquities done by ASI recently.

• It is the premier organization for archaeological research and the protection of cultural heritage in India. 
• Established in - 1861 by Alexander Cunningham, 1^st Director General.
• Headquarters- The Director-General leads the ASI from its headquarters in New Delhi.
• Purpose- Its primary role is to survey, explore, and excavate archaeological sites, and conserve national monuments.
• Structure- It operates through 24 circles, museums, and specialized branches, including excavations, epigraphy, science, horticulture, and underwater archaeology.
• Functions - The ASI functions under the Ancient Monuments and Archaeological Sites and Remains Act (AMASR Act), 1958, and manages the Antiquities and Art Treasure Act, 1972.
  • Monument Protection - Administers and maintains over 3,690 ancient monuments and archaeological sites of national importance under the AMASR Act, 1958.
  • Research and Excavation - Conducts systematic scientific explorations to unearth India's past, notably discovering the Indus Valley Civilisation in the 1920s.
  • Antiquities Regulation- Regulates the export of non-antiquities and prevents illicit trafficking under the Antiquities and Art Treasures Act, 1972.
  • Public Engagement- Manages over 50 site museums located near historical excavations and publishes academic journals like Indian Archaeology – A Review.
• World Heritage Sites in India - 44 UNESCO sites managed by ASI.
• The 44 sites are categorized into 3 types to ensure a balance of cultural and natural preservation
  • Cultural (36 sites) - Includes iconic monuments like the Taj Mahal, Ajanta Caves, Hampi, and the Victorian Gothic and Art Deco Ensembles of Mumbai.
  • Natural (7 sites) - Protects critical ecosystems like Kaziranga National Park, Sundarbans, and the Western Ghats and
  • Mixed (1 site) - Khangchendzonga National Park in Sikkim is uniquely recognized for both its natural beauty and its sacred spiritual meaning to indigenous communities.

Italy (61 sites) and China (60 sites) currently hold the highest number of World Heritage Sites globally and India holds the 6^th place by holding 44 sites.

• Latest Inscriptions in India (2024–2025)
• Maratha Military Landscapes (2025)- India's 44th site, consisting of 12 historic forts (11 in Maharashtra and 1 in Tamil Nadu) that demonstrate the strategic military architecture of the Maratha Empire.
• Moidams – Ahom Mound Burials (2024) - Located in Assam, these are the 700-year-old royal burial mounds of the Ahom dynasty and the first cultural site from Northeast India to be inscribed.

Reference

PIB | ASI