TB Elimination in India: What It Means for Generic Drug Makers

Progress on TB elimination in India has drawn fresh attention, with the Union Health Minister J.P. Nadda launching JOSH (Joint Squad for Health) Teams to take the campaign to the grassroots.

The initiative seeks to strengthen youth participation and community-driven efforts to eliminate tuberculosis.

The launch follows the minister’s assertion that the country is closing in on its goal, backed by the World Health Organization’s latest data.

According to the minister, incidence has fallen 21 per cent since 2015, nearly twice the global rate, while treatment coverage stands at 92 per cent.

Yet the story is not only about public health. Every additional patient detected and treated adds to demand for medicines, and India’s generic manufacturers sit at the center of that supply chain.

This News report examines what the numbers mean for drug demand, who supplies the medicines, and whether newer regimens are reaching patients.

What does the Latest TB Data Show?

The WHO’s Global TB Report 2025 shows incidence falling from 237 to 187 per lakh population between 2015 and 2024. The key figures include:

• Detection: 26.18 lakh patients were detected in 2024, the highest in a single year.
• Treatment: Coverage is 92 per cent, with a 90 per cent success rate.
• Burden: India still accounts for about 26 per cent of global TB cases, the highest share of any country.

Nadda credited the gains to a people’s movement under the TB Mukt Bharat campaign. For the pharmaceutical sector, higher notification means higher procurement under the National TB Elimination Program (NTEP).

Also Read: AI-Augmented Clinical Trials & Drug Development Evolution in India

Who Supplies India’s TB Drugs?

India’s generic industry is the backbone of TB treatment, both at home and abroad. When the primary bedaquiline patent expired, Lupin, Natco and Macleods were reported to be poised to launch generic versions.

The Stop TB Partnership’s Global Drug Facility also secured licenses from Johnson & Johnson to supply generic bedaquiline to most low- and middle-income countries. That arrangement matters beyond India, since many low-income countries source their TB medicines through Indian manufacturers.

Bedaquiline and the BPaLM Regimen After the Patent Expiry

Bedaquiline is central to modern treatment of drug-resistant TB. The main developments are:

• India’s patent office rejected J&J’s request to extend its patent protection, opening the way for generics that were expected to cost roughly 80 per cent less for a six-month course.
• Before generic competition, bedaquiline accounted for USD 272 of the USD 570 price of the BPaLM regimen.
• The related BPaL regimen is now used for patients with multi-drug-resistant or extensively drug-resistant TB, can halve treatment duration, and is funded by the national program.

Bedaquiline has been described as the backbone of the more effective, patient-friendly regimens now recommended by the WHO. Access, however, may not be uniform. Earlier reporting noted that bedaquiline was available in most large-city TB clinics but not in smaller towns and rural areas.

Elimination Claim Versus Ground Reality

Nadda had earlier said India would eliminate TB by the end of 2025, five years ahead of the 2030 global target.

With incidence still at 187 per lakh, the term “elimination” is being used as a goal rather than a description of current status. To narrow that gap, the Centre introduced JOSH Teams on 8 October.

The teams combine Class-I officers, MY Bharat volunteers and NCC cadets to spread information on TB symptoms, prevention, timely diagnosis and treatment completion, and to reduce stigma.

The first phase covers 55 districts in 11 states, and Nadda said 58,000 volunteers will go from village to village.

Key indicators to watch include:

• Rural supply: States including Maharashtra, Bihar, Chhattisgarh, Odisha and Karnataka had complained of poor TB medicine supply for nearly a year. Centre has promised at least six months of advance stock.
• Procurement and pricing: Bedaquiline from Lupin and Macleods is available through the Global Drug Facility at USD 90 per course, down from USD 194 in August 2023.
• Nutrition support: Monthly aid under Ni-Kshay Poshan Yojana was doubled from Rs 500 to Rs 1,000 for the full treatment period, with energy-dense supplements added for underweight patients.
• Diagnostics: India is using hundreds of portable AI-enabled X-ray machines for community screening and has scaled up molecular testing, but access remains uneven and sputum collection and transport need strengthening.

For drug makers, the opportunity is steady demand backed by government procurement. The test is whether supply, pricing and access keep pace with the policy ambition.