Private hospitals drive record TB detections in FY23, public sector lagged in performance in Rajasthan, Maharashtra

India's National Tuberculosis (TB) Elimination Programme (NTEP) reported the highest-ever TB notifications in FY2023, surpassing 92% of its annual target with 25.3 million cases identified. 

The data available on Nikshay, the Indian information technology system for the management of TB cases, indicated a significant shift of private healthcare providers emerging as the key drivers, for the first time exceeding the public sector's contribution. 

Private facilities notified over 8.3 million cases, a 15% jump from 2022, while the public sector managed 1.7 million. Uttar Pradesh (UP) led the charge with a 49% rise in private notifications, according to government data.  

"Last year was a significant year for TB as the country achieved its highest-ever notifications, reflecting better case detection measures. Uttar Pradesh alone has notified over 6 lakh patients (which is more than 100 percent of its target) with an exponential increase in reporting from the private sector. Our efforts to engage with private healthcare providers and hospitals and facilitate free care have shown immediate results,” said Surya Kant, Professor and Head, Department of Respiratory Medicine at King George's Medical University, Lucknow, UP. Kant is also a Member, National Task Force, National TB Elimination Program. 

This trend, however, presented a potential for reaching underserved populations and boosting early detection, yet raised concerns about ensuring quality care and data sharing between public and private sectors. 

“Alongside initiatives such as active case finding, Nikshay Poshan Yojna, Nikshay Mitra Yojna, and incentives to healthcare workers for TB detection under the Pradhan Mantri TB Mukt Bharat Yojna, visibility about the disease has increased. This has helped involve diverse people, creating a community-led movement to mitigate stigma around the disease and ensure more people are getting tested,” said Kant.

The public sector, while improved, fell short in three states – Rajasthan, Maharashtra, and Chhattisgarh – highlighting the need for focused interventions. Rajasthan's case is particularly worrisome as indicated in the data, with private sector notifications declining for the first time (-5.02%), while public sector contributions remained stagnant.

Public health experts emphasized the need for further research to understand the uneven private sector growth and effectiveness of specific interventions. They further said that examining socio-economic factors alongside TB data is crucial for developing targeted strategies. 

“TB is a major development priority for the central and state governments, ensuring that the program has all appropriate resources to control the spread of TB and ensure patients are well-supported through their treatment journeys,” he said. 

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