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TB in India: A Persistent Public Health Challenge Worsened by Air Pollution, Malnutrition & Stigma

Alok Uniyal by Alok Uniyal
March 24, 2025
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TB in India: A Persistent Public Health Challenge Worsened by Air Pollution, Malnutrition & Stigma
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Despite medical advancements, TB remains a leading cause of death in India, with rising cases linked to air pollution, undernutrition, and delayed care due to stigma. On the World Tuberculosis Day on March 24, health experts said that early testing, government programs, vaccination, and public awareness are crucial to controlling its spread and improving treatment outcomes.

“Many Indians carry Mycobacterium tuberculosis in a latent (inactive) form. Exposure to high levels of air pollution can trigger the activation of latent TB by impairing lung function and immune responses, leading to active TB disease. For TB patients, air pollution can worsen lung inflammation, making it harder for them to recover even with proper treatment,” said Dr. Akshay Budhraja, Senior Consultant & HOD, Respiratory & Sleep Medicine, Aakash Healthcare.
At the same time, Dr Neetu Jain, Senior Consultant, Pulmonology, PSRI Hospital felt that, “Undernutrition isn’t just a risk factor—it’s the fuel that drives TB. When families struggle to afford nutritious food, their immune defenses weaken, creating the perfect conditions for TB to take hold and spread”

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Stigma and delayed care exacerbate TB. Many people with TB fear being judged, ostracized, or even losing their jobs or social standing. In many communities. They hesitate to seek medical help, allowing the disease to progress and spread to others, said the doctors.
“Fear of discrimination forces many to hide symptoms. Patients often seek help only when coughing blood. Early diagnosis is crucial in controlling TB. Many delay seeking medical attention due to stigma, leading to advanced disease stages that are harder to treat,” according to Dr. Manav Manchanda, Director and Head of Respiratory, Critical Care, and Sleep Medicine at the Asian Hospital.

Dr Praveen Gupta, Principal Director and Chief of Neurology, Fortis Hospital warned that tuberculosis affecting the central nervous system is a serious yet often overlooked complication. Tuberculous meningitis (TBM) is its most severe neurological manifestation, characterized by meningeal inflammation, elevated intracranial pressure, and a high risk of long-term neurocognitive impairment. If not diagnosed and treated promptly, TBM can lead to devastating outcomes, including strokes, hydrocephalus, and irreversible brain damage.”

“One of our biggest hurdles is ensuring patients complete their treatment which typically involves a combination of antibiotics taken over six to nine months. Interruptions can lead to drug resistance, making the disease more lethal and harder to cure,” added Dr Sushrut Ganpule, Consultant – Chest Medicine, Jupiter Hospital, Baner, Pune.

According to reports, India bears a substantial burden of TB cases globally. For instance, the WHO Global TB Report 2023 states that India reported 2.8 million new TB cases in 2022, a 13% rise from pre-pandemic levels. An estimated 340,000 Indians die yearly from TB—equivalent to 930 daily deaths.

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