India's plan to eliminate tuberculosis by 2025: converting rhetoric into reality

The Government of India announced its plan to eliminate tuberculosis (TB) by 2025 during the Union Budget address last month.1 The declaration is extraordinarily ambitious, considering that India accounts for 27% of the world's 10.4 million new TB cases, and 29% of the 1.8 million TB deaths globally.2 India also accounts for 16% of the estimated 480 000 new cases of multidrug-resistant TB. The End TB Strategy by WHO aims to end the global TB epidemic, with targets to reduce TB deaths by 95% and to cut new cases by 90% by 2035.3 While high-level political commitment is welcome and necessary, the real question now is how India can go from rhetoric to real progress? We offer some suggestions that might help bridge the gap between ambition and reality. First and foremost, India needs to give priority to and begin investing in health. For decades, governmental expenditure on health has been one of the lowest in the world at 1.4% of the GDP (but even lower in the previous years).4 While the 2017 Union Budget has allocated additional funding for health, the allocation will substantially fall short of the 2.5% of the GDP that has been considered a realistic goal in the draft National Health Policy 2015.5 The budget for India's Revised National TB …