Mumbai has recorded a 28% decline in multi-drug resistant tuberculosis (MDR-TB) cases over the past three years. According to recent data, the number of annual drug-resistant TB cases decreased from 5,698 in 2022 to 4,080 in 2025.
This decline reflects ongoing public health efforts to strengthen diagnosis, treatment, and monitoring under the city’s tuberculosis control programmes.
Introduction of Shorter BPaLM Treatment Regimen
A key development in TB treatment has been the introduction of the BPaLM regimen, a newer drug combination designed for drug-resistant tuberculosis. This treatment significantly reduces the duration of therapy—from the traditional 18 months to just six months.
In Mumbai, 1,093 drug-resistant TB patients have already received this regimen. However, several patients did not qualify for this treatment under existing clinical guidelines.
For example, the regimen is currently not recommended for children below 14 years of age, patients with extrapulmonary tuberculosis (EPTB), or individuals who have previously been treated with bedaquiline, a key component of the BPaLM drug combination.
Overall TB Cases Also Declining
In addition to the reduction in drug-resistant cases, overall tuberculosis cases in Mumbai have also declined in recent years.
- 63,575 cases were reported in 2023
- 60,633 cases were recorded in 2024
- 54,390 cases were reported in 2025
Out of the total cases reported in 2025, 48,835 patients were residents of Mumbai, indicating a noticeable decline in the city’s TB burden.
Rise in Extrapulmonary TB Cases
As reported by TOI, despite the overall reduction in TB cases, health officials have observed a slight increase in extrapulmonary tuberculosis (EPTB).
In 2024, EPTB accounted for 38% of all TB cases, but this figure increased to 40% in 2025. Additionally, around 6% of the total TB cases involved paediatric patients.
This trend highlights the need for improved diagnostic approaches for TB cases that affect organs outside the lungs.
Concerns Over Possible Underdiagnosis
Some frontline healthcare workers have raised concerns that the decline in drug-resistant TB cases may partly reflect underdiagnosis rather than an actual reduction in cases.
They attribute this issue to a shortage of CB-NAAT cartridges, which are used for automated rapid molecular testing to detect tuberculosis and drug resistance.
A staff member from the TB department noted that testing for extrapulmonary TB has also declined in recent years. Previously, private doctors and laboratories partnered with the Brihanmumbai Municipal Corporation (BMC) to conduct such tests. However, several of these facilities reportedly stopped testing after not receiving payments from the BMC over the past two years.
A senior TB specialist in Mumbai also pointed out that biopsy procedures for diagnosing EPTB decreased last year, largely due to funding constraints.
Health Officials Emphasize Stable Testing Levels
Despite these concerns, BMC Executive Health Officer Dr. Daksha Shah maintains that the city’s testing levels have remained consistent.
She explained that data from both CB-NAAT and TrueNAT diagnostic systems shows that Mumbai conducted around 2.2 lakh TB tests annually in both 2024 and 2025.
According to Dr. Shah, the steady testing levels indicate that the reduction in drug-resistant TB cases reflects genuine progress.
“We are confident that cases of drug-resistant TB have declined in the city because of the sustained efforts taken by the health department. Early diagnosis through CB-NAAT testing has helped interrupt the chain of transmission,” she said.
Continued Efforts Needed
While the decline in MDR-TB cases is encouraging, experts emphasize that sustained surveillance, timely diagnosis, and uninterrupted treatment remain essential to control tuberculosis effectively. Strengthening diagnostic infrastructure and ensuring adequate funding will also play a crucial role in maintaining the progress achieved so far.