A little over 50 days ago, India launched an ambitious project named the 100-day tuberculosis challenge with the goal of boosting patient detection, and service delivery for tuberculosis amongst risk groups. As we crossed the midway mark a week ago, it is heartening to note that some states are performing well in mass screening using mobile diagnostic vans, Artificial Intelligence (AI)-based tools, and rapid molecular testing. But, in order to increase impact in these fifty days, we will need to step up our screening, integrate more advanced diagnostic technologies, as well as bolster peripheral primary health care services.
A few days following the launch of the initiative, many states increased their Active Case Finding (ACF) campaigns on chronic patients, under-nourished zones, and other vulnerable geographies.
In Odisha, an extensive screening campaign is ongoing in the district using mobile diagnostic units as part of the Nikshay Vahan initiative. Likewise, Tamil Nadu has already conducted screening on more than 100,000 people in Tiruchi district, aiming for proactive detection among high-risk groups. Incorporation of AI tools for interpretation of chest X-rays has significantly improved the speed and accuracy of TB case detection in Karnataka.
The advancement of rapid molecular diagnostics has tremendously transformed this initiative, and we have seen success with indigenous technologies like Truenat® that provide results in hours instead of days. For mass screening to be effective within the restrictive time limits, it has to be combined with portable imaging technologies that enable real-time lung screening, especially in rural and remote regions where there is minimal access to large diagnostic centres. Further, AI-based chest X-ray analysis significantly increases the detection rates by ensuring that all potentially positive TB suspects are immediately identified for molecular confirmation test.
For the second segment of the 100-day TB challenge, understanding gaps in screening’s coverage requires crucial attention. Let us further analyse these gaps.
Expanding reach: Deploying mobile diagnostic units, equipped with both molecular testing and portable X-ray machines, can help in penetrating the mass screening in tribal, migrant and urban slum populations.
Strengthening last-mile connectivity: Screening is just the first step. Ensuring timely follow-ups, immediate treatment initiation, and patient adherence remains critical. Digital tracking through the Ni-kshay platform must be reinforced to reduce dropout rates.
Public-private collaborations: Government initiatives, when coupled with private sector innovation in portable imaging and rapid diagnostics with AI integration, can dramatically accelerate TB elimination efforts.
The first 50 days of the 100-day TB challenge have showcased momentum, but the procurement of portable X-ray machines and AI-assisted diagnostic tools on scale can further strengthen state-led programmes. Moreover, the public health protocols already in place can be expanded so that even the most underserved regions can benefit from early detection and prompt treatment.
The remaining days are the most vital. Targeted screening and innovative diagnostic solutions along with reinforced last mile health care connectivity can go a long way in ensuring that this initiative has a sustained impact on India’s fight against TB. The time to act is now – because every single undiagnosed case is a milestone missed in our final destination of a TB-free India
This article is authored by Dr Randeep Guleria, former director, All India Institute of Medical Sciences and public health advocate, New Delhi.
