Lok Sabha Question No. 2109 (UNSTARRED), answered on 2021-12-10
Subject: Increase in TB Deaths due to COVID-19 Pandemic
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Vellalath Kochukrishnan Nair. Sreekandan

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 2109 TO BE ANSWERED ON THE 10 th  DECEMBER, 2021

## INCREASE IN TB DEATHS DUE TO COVID-19 PANDEMIC

## 2109.  SHRI V.K. SREEKANDAN

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- a) whether the Government has taken note that the COVID-19 pandemic has reversed years of progress  in  tackling  tuberculosis  and  for  the  first  time  in  over  a  decade,  TB  deaths  have increased;
- b) if so, the details thereof;
- c) whether  as  per  the  World  Health  Organisation,  India  was  worse  on  the  list  of  countries which contributed most to the global reduction in TB notification between 2019 and 2020; and
- d) if so, the details thereof?

## ANSWER

## THE MINISTER OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a)-(b) The Government is aware of decline in TB case notification during the year 2020. A total of 18.12 lakh TB cases were notified under the programme in 2020 (Jan-Dec), which was 25% less than the total cases notified in 2019 (which was 24.00 lakhs). In 2021, in spite of a larger 2 nd wave of COVID-19, the programme has been able to notify 17.63 lakh TB cases (till Oct,2021), which is 18% higher as compared to 2020 (Jan-Oct).

The deaths due to TB reported under the programme has remained static in 2020 at around 4%, similar to the pre-COVID times.

(c)-(d): India has reported a decline of 25% in TB case notification in 2020 as compared to 2019.

Among the 49 High burden countries that are listed by the World Health Organization in 2020, there are 10 other countries above India, who have reported a decline in notification of more than 25%.

********************

Statewise TB Case Notification & Death Rate for 2019 & 2020

| Sl   |                                          | 2020                 | 2020        | 2019                 | 2019       |
|------|------------------------------------------|----------------------|-------------|----------------------|------------|
| No.  | State                                    | TB patients Notified | Death Rate  | TB patients Notified | Death Rate |
| 1    | Andaman &Nicobar Islands                 | 554                  | 25 (4.5%)   | 523                  | 12 (2%)    |
| 2    | Andhra Pradesh                           | 96469                | 3585 (3.7%) | 90680                | 3636 (4%)  |
| 3    | Arunachal Pradesh                        | 2864                 | 64 (2.2%)   | 2900                 | 59 (2%)    |
| 4    | Assam                                    | 47779                | 1840 (3.9%) | 41676                | 1562 (4%)  |
| 5    | Bihar                                    | 123027               | 2975 (2.4%) | 106189               | 2577 (2%)  |
| 6    | Chandigarh                               | 3454                 | 114 (3.3%)  | 3222                 | 94 (3%)    |
| 7    | Chhattisgarh                             | 42845                | 1603 (3.7%) | 40527                | 1403 (3%)  |
| 8    | Dadra and Nagar Haveli and Daman and Diu | 984                  | 25 (2.5%)   | 952                  | 29 (3%)    |
| 9    | Delhi                                    | 93819                | 2111 (2.3%) | 71928                | 1367 (2%)  |
| 10   | Goa                                      | 2271                 | 72 (3.2%)   | 2240                 | 71 (3%)    |
| 11   | Gujarat                                  | 150999               | 6870 (4.5%) | 148695               | 6436 (4%)  |
| 12   | Haryana                                  | 72370                | 2809 (3.9%) | 61983                | 2284 (4%)  |
| 13   | Himachal Pradesh                         | 17368                | 837 (4.8%)  | 16595                | 661 (4%)   |
| 14   | Jammu &Kashmir                           | 11345                | 295 (2.6%)  | 11890                | 278 (2%)   |
| 15   | Jharkhand                                | 56524                | 1314 (2.3%) | 48669                | 1163 (2%)  |
| 16   | Karnataka                                | 87168                | 5605 (6.4%) | 78918                | 4868 (6%)  |
| 17   | Kerala                                   | 25267                | 1828 (7.2%) | 24572                | 1163 (5%)  |
| 18   | Ladakh                                   | 412                  | 23 (5.6%)   | NA                   | NA         |
| 19   | Lakshadweep                              | 22                   | 2 (9.1%)    | 19                   | 0 (0%)     |
| 20   | Madhya Pradesh                           | 183177               | 5485 (3.0%) | 152846               | 4316 (3%)  |
| 21   | Maharashtra                              | 210754               | 8785 (4.2%) | 191294               | 7114 (4%)  |
| 22   | Manipur                                  | 2623                 | 74 (2.8%)   | 2862                 | 72 (3%)    |
| 23   | Meghalaya                                | 4963                 | 186 (3.7%)  | 4459                 | 145 (3%)   |
| 24   | Mizoram                                  | 2930                 | 48 (1.6%)   | 2576                 | 53 (2%)    |
| 25   | Nagaland                                 | 4693                 | 108 (2.3%)  | 4322                 | 95 (2%)    |
| 26   | Odisha                                   | 52279                | 2738 (5.2%) | 48307                | 2522 (5%)  |
| 27   | Puducherry                               | 1565                 | 116 (7.4%)  | 1542                 | 92 (6%)    |
| 28   | Punjab                                   | 58178                | 2824 (4.9%) | 52217                | 2355 (5%)  |
| 29   | Rajasthan                                | 169311               | 4767 (2.8%) | 152547               | 4178 (3%)  |

|        |               | 2020                 | 2020         | 2019                 | 2019         |
|--------|---------------|----------------------|--------------|----------------------|--------------|
| Sl No. | State         | TB patients Notified | Death Rate   | TB patients Notified | Death Rate   |
| 30     | Sikkim        | 1229                 | 45 (3.7%)    | 1340                 | 32 (2%)      |
| 31     | Tamil Nadu    | 109772               | 5365 (4.9%)  | 101101               | 4083 (4%)    |
| 32     | Telangana     | 69076                | 2392 (3.5%)  | 51318                | 1850 (4%)    |
| 33     | Tripura       | 2936                 | 173 (5.9%)   | 2702                 | 127 (5%)     |
| 34     | Uttar Pradesh | 486310               | 18409 (3.8%) | 406312               | 13424 (3%)   |
| 35     | Uttarakhand   | 24504                | 894 (3.6%)   | 20561                | 690 (3%)     |
| 36     | West Bengal   | 108497               | 5417 (5.0%)  | 101033               | 4571 (5%)    |
| 37     | India         | 2328338              | 89823 (3.9%) | 2049517              | 73382 (4.4%) |

High TB Burden Countries decline in TB Notification

| Sr. No.   | PERCENTAGE CHANGE IN NOTIFICATION OF 2020 COMPARED TO 2019 IN 49 HIGH BURDEN COUNTRIES   | PERCENTAGE CHANGE IN NOTIFICATION OF 2020 COMPARED TO 2019 IN 49 HIGH BURDEN COUNTRIES   | PERCENTAGE CHANGE IN NOTIFICATION OF 2020 COMPARED TO 2019 IN 49 HIGH BURDEN COUNTRIES   | PERCENTAGE CHANGE IN NOTIFICATION OF 2020 COMPARED TO 2019 IN 49 HIGH BURDEN COUNTRIES   |
|-----------|------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------|
| Sr. No.   | COUNTRIES                                                                                | NOTIFICATION (SOURCE: Global TB Report)                                                  | NOTIFICATION (SOURCE: Global TB Report)                                                  | NOTIFICATION (SOURCE: Global TB Report)                                                  |
| Sr. No.   | COUNTRIES                                                                                | 2019                                                                                     | 2020                                                                                     | %CHANGE IN 2020 AGAINST 2019                                                             |
| 1         | Philippines                                                                              | 4,09,167                                                                                 | 2,56,541                                                                                 | -37%                                                                                     |
| 2         | Republic of Moldova                                                                      | 2,809                                                                                    | 1,767                                                                                    | -37%                                                                                     |
| 3         | Lesotho                                                                                  | 7,059                                                                                    | 4,565                                                                                    | -35%                                                                                     |
| 4         | Belarus                                                                                  | 2,207                                                                                    | 1,514                                                                                    | -31%                                                                                     |
| 5         | Indonesia                                                                                | 5,59,847                                                                                 | 3,84,025                                                                                 | -31%                                                                                     |
| 6         | Kyrgyzstan                                                                               | 6,138                                                                                    | 4,241                                                                                    | -31%                                                                                     |
| 7         | Ukraine                                                                                  | 25,379                                                                                   | 17,533                                                                                   | -31%                                                                                     |
| 8         | Tajikistan                                                                               | 5,755                                                                                    | 4,148                                                                                    | -28%                                                                                     |
| 9         | Uzbekistan                                                                               | 16,272                                                                                   | 12,111                                                                                   | -26%                                                                                     |
| 10        | Eswatini                                                                                 | 2,876                                                                                    | 2,143                                                                                    | -25%                                                                                     |
| 11        | India                                                                                    | 21,62,323                                                                                | 16,29,301                                                                                | -25%                                                                                     |
| 12        | Peru                                                                                     | 31,764                                                                                   | 23,755                                                                                   | -25%                                                                                     |
| 13        | Zimbabwe                                                                                 | 21,008                                                                                   | 15,728                                                                                   | -25%                                                                                     |
| 14        | Azerbaijan                                                                               | 4,823                                                                                    | 3,683                                                                                    | -24%                                                                                     |
| 15        | Kazakhstan                                                                               | 12,501                                                                                   | 9,603                                                                                    | -23%                                                                                     |
| 16        | Myanmar                                                                                  | 1,34,501                                                                                 | 1,03,373                                                                                 | -23%                                                                                     |
| 17        | Bangladesh                                                                               | 2,91,595                                                                                 | 2,30,081                                                                                 | -21%                                                                                     |
| 18        | Libya                                                                                    | 2,215                                                                                    | 1,748                                                                                    | -21%                                                                                     |
| 19        | Botswana                                                                                 | 3,089                                                                                    | 2,484                                                                                    | -20%                                                                                     |
| 20        | Russian Federation                                                                       | 73,328                                                                                   | 58,723                                                                                   | -20%                                                                                     |
| 21        | Namibia                                                                                  | 7,801                                                                                    | 6,509                                                                                    | -17%                                                                                     |
| 22        | Pakistan                                                                                 | 3,28,312                                                                                 | 2,72,990                                                                                 | -17%                                                                                     |
| 23        | Angola                                                                                   | 74,105                                                                                   | 63,147                                                                                   | -15%                                                                                     |
| 24        | Kenya                                                                                    | 84,345                                                                                   | 71,646                                                                                   | -15%                                                                                     |
| 25        | China                                                                                    | 7,28,265                                                                                 | 6,24,715                                                                                 | -14%                                                                                     |
| 26        | Nepal                                                                                    | 31,495                                                                                   | 27,282                                                                                   | -13%                                                                                     |
| 27        | Brazil                                                                                   | 85,154                                                                                   | 74,826                                                                                   | -12%                                                                                     |
| 28        | Sierra Leone                                                                             | 17,794                                                                                   | 15,706                                                                                   | -12%                                                                                     |

| Sr. No.   | PERCENTAGE CHANGE IN NOTIFICATION OF 2020 COMPARED TO 2019 IN 49 HIGH BURDEN COUNTRIES   | PERCENTAGE CHANGE IN NOTIFICATION OF 2020 COMPARED TO 2019 IN 49 HIGH BURDEN COUNTRIES   | PERCENTAGE CHANGE IN NOTIFICATION OF 2020 COMPARED TO 2019 IN 49 HIGH BURDEN COUNTRIES   | PERCENTAGE CHANGE IN NOTIFICATION OF 2020 COMPARED TO 2019 IN 49 HIGH BURDEN COUNTRIES   |
|-----------|------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------|
| Sr. No.   | COUNTRIES                                                                                | NOTIFICATION (SOURCE: Global TB Report)                                                  | NOTIFICATION (SOURCE: Global TB Report)                                                  | NOTIFICATION (SOURCE: Global TB Report)                                                  |
| Sr. No.   | COUNTRIES                                                                                | 2019                                                                                     | 2020                                                                                     | %CHANGE IN 2020 AGAINST 2019                                                             |
| 29        | Gabon                                                                                    | 5,399                                                                                    | 4,879                                                                                    | -10%                                                                                     |
| 30        | Malawi                                                                                   | 16,902                                                                                   | 15,133                                                                                   | -10%                                                                                     |
| 31        | Mongolia                                                                                 | 4,277                                                                                    | 3,861                                                                                    | -10%                                                                                     |
| 32        | Cameroon                                                                                 | 24,319                                                                                   | 22,056                                                                                   | -9%                                                                                      |
| 33        | South Africa                                                                             | 2,09,545                                                                                 | 1,91,074                                                                                 | -9%                                                                                      |
| 34        | Papua New Guinea                                                                         | 30,671                                                                                   | 28,227                                                                                   | -8%                                                                                      |
| 35        | Uganda                                                                                   | 65,897                                                                                   | 60,887                                                                                   | -8%                                                                                      |
| 36        | Democratic People's Republic of Korea                                                    | 95,722                                                                                   | 89,640                                                                                   | -6%                                                                                      |
| 37        | Congo                                                                                    | 11,802                                                                                   | 11,175                                                                                   | -5%                                                                                      |
| 38        | Guinea                                                                                   | 16,390                                                                                   | 15,612                                                                                   | -5%                                                                                      |
| 39        | Ethiopia                                                                                 | 1,11,039                                                                                 | 1,08,193                                                                                 | -3%                                                                                      |
| 40        | Viet Nam                                                                                 | 1,02,503                                                                                 | 99,852                                                                                   | -3%                                                                                      |
| 41        | Thailand                                                                                 | 87,789                                                                                   | 85,837                                                                                   | -2%                                                                                      |
| 42        | Mozambique                                                                               | 96,024                                                                                   | 96,203                                                                                   | 0%                                                                                       |
| 43        | Somalia                                                                                  | 16,918                                                                                   | 17,203                                                                                   | 2%                                                                                       |
| 44        | United Republic of Tanzania                                                              | 81,208                                                                                   | 84,791                                                                                   | 4%                                                                                       |
| 45        | Central African Republic                                                                 | 12,046                                                                                   | 12,610                                                                                   | 5%                                                                                       |
| 46        | Guinea-Bissau                                                                            | 2,407                                                                                    | 2,543                                                                                    | 6%                                                                                       |
| 47        | Zambia                                                                                   | 36,150                                                                                   | 40,000                                                                                   | 11%                                                                                      |
| 48        | Democratic Republic of the Congo                                                         | 1,78,527                                                                                 | 2,00,955                                                                                 | 13%                                                                                      |
| 49        | Nigeria                                                                                  | 1,17,320                                                                                 | 1,35,784                                                                                 | 16%                                                                                      |