Ending Tuberculosis in Nepal: A Comprehensive Journey Towards a TB-Free Future

Tuberculosis (TB) remains a significant public health challenge globally, and Nepal is no exception. As we commemorate World TB Day on March 24, 2025, under the theme “Yes! We Can End TB: Commit, Invest, Deliver!”, Nepal continues its relentless fight against this infectious disease. This blog explores Nepal’s efforts to combat TB. It highlights key statistics, challenges, and achievements. The content also covers the roadmap to a TB-free future. We’ll also explore the evolution of World TB Day themes over the years. We will provide actionable insights for stakeholders. The content will also benefit communities alike.

Understanding Tuberculosis in Nepal: The Current Landscape

Tuberculosis, caused by Mycobacterium tuberculosis, is a contagious airborne disease primarily affecting the lungs. In Nepal, TB is among the top ten causes of death, with significant socio-economic impacts on affected households. According to the Global TB Report 2024, Nepal accounted for an estimated 68,000 people with TB. There were 16,000 deaths in 2023. Additionally, the burden of drug-resistant TB (DR-TB) is alarming, with an estimated 3,000 DR-TB cases annually in 2023.

The Tuberculosis Profile for Nepal (2023/24) by the National Tuberculosis Control Center (NTCC) provides critical insights:

Total TB Incidence: 68,000 (229 per 100,000 population)
Notified TB Cases: 40,776 (59% of the estimated cases)
Drug-Resistant TB (DR-TB): 756 cases notified out of an estimated 3,000
Treatment Success Rate (DS-TB): 92%
Treatment Success Rate (DR-TB): 78%
TB-Related Mortality: 16,000 (54 per 100,000 population)

Despite these challenges, Nepal has made significant strides. Between 2000 and 2023, the country saved nearly 10 lakh lives through effective TB interventions. However, the data also reveals a gap. Out of every two people with TB in Nepal, one remains undetected or unnotified. This highlights the need for intensified case-finding efforts.

Facts Sheet of TB Nepal

Nepal’s Commitment to Ending TB: The National Strategy

Nepal’s National Tuberculosis Program (NTP) aligns with the global End TB Strategy. The program aims to reduce TB deaths by 95% and new cases by 90% by 2035. These targets are compared to 2015 levels. The National Strategic Plan (NSP) for TB (2021-2026) outlines key objectives:

Universal Access to TB Services: Ensuring timely diagnosis and treatment for all forms of TB, including DR-TB.
Intensified Case Finding: Targeting high-risk groups such as the elderly, children, and those in poverty.
Community Engagement: Strengthening partnerships with local communities, private sectors, and stakeholders.
Innovative Diagnostics: Expanding access to advanced tools like GeneXpert and digital chest X-rays for early detection.

The TB Free Nepal Initiative is scaled up to 149 local levels. It emphasizes a multi-sectoral approach to TB control. The initiative integrates health systems with social protection mechanisms.

Achievements and Progress: A Look at the Numbers

Nepal’s progress in TB control is commendable, as outlined in the Tuberculosis Profile for World TB Day 2025:

Reduction in TB Deaths: From 2020 to 2023/24, TB deaths reduced by 11%. This aligns with the 2025 milestone of a 75% reduction.
TB Incidence Rate: The incidence rate dropped to 229 per 100,000 population in 2023/24, a 15% reduction from 2015 levels.
Treatment Success Rates: Drug-susceptible TB (DS-TB) treatment success stands at 92%, while DR-TB success is at 78%.
TB-Affected Households Facing Catastrophic Costs: Reduced to 5% in 2023/24, down from 11% in earlier surveys.

The NTP has also scaled up diagnostic and treatment facilities:

Microscopy Centers: 786 (2023/24)
GeneXpert Sites: 117 (expanded to 21 sites in 2023/24)
DR-TB Treatment Centers: 23
TB Preventive Therapy (TPT): 4,346 individuals enrolled in 2023/24

Challenges in Nepal’s Fight Against TB

Despite progress, Nepal faces several hurdles in its mission to end TB:

Funding Gap: The NSP is currently 43% underfunded, with only 109.52 million USD available out of the required 191.84 million USD.
Undetected Cases: 22,244 TB cases (40% of the estimated burden) remain undetected annually.
Drug-Resistant TB: Only 756 out of 3,000 estimated DR-TB cases were notified in 2023/24.
Social Determinants: Poverty, malnutrition, and limited access to healthcare exacerbate TB prevalence, with 68% of TB cases linked to poverty.
Logistical Challenges: Ensuring an uninterrupted supply of TB drugs and diagnostics remains a concern.

World TB Day Themes: A Journey of Awareness and Action

World TB Day, observed annually on March 24, commemorates the discovery of the TB bacillus by Dr. Robert Koch in 1882. Each year, the day is marked by a unique theme to galvanize global action. Here’s a table of World TB Day themes from 2015 to 2025:

Year	Theme
2015	Reach the 3 Million
2016	Unite to End TB
2017	Wanted: Leaders for a TB-Free World
2018	It’s Time!
2019	It’s Time to End TB
2020	It’s Time to End TB
2021	The Clock is Ticking
2022	Invest to End TB. Save Lives
2023	Yes! We Can End TB
2024	Yes! We Can End TB
2025	Yes! We Can End TB: Commit, Invest, Deliver

The themes reflect a progression. Initially, they focused on raising awareness from 2015 to 2017. Then, they emphasized urgent action from 2018 to 2021. Finally, they concentrate on investment and commitment from 2022 to 2025. The 2025 theme emphasizes the need for sustained financial and political commitment to deliver on the promise of ending TB.

TB Prevention and Treatment: What You Need to Know

The NTCC’s Press Briefing for World TB Day 2024 outlines key preventive and treatment strategies:

Symptoms of TB: Persistent cough for over 2 weeks, fever, night sweats, weight loss, and fatigue.
Prevention Tips: Maintain good ventilation, cover your mouth while coughing, avoid smoking, and ensure early diagnosis.
Treatment Regimens:
- Drug-Susceptible TB (DS-TB): 6-month regimen (2HRZE/4HR).
- Drug-Resistant TB (DR-TB): 9-20 month regimens, depending on resistance patterns.
- TB Preventive Therapy (TPT): For high-risk groups like children and HIV-positive individuals.

The Tuberculosis Treatment Regimen document provides detailed dosing for adults and children, ensuring standardized care across Nepal.

Leaflet for HE

The Way Forward: Nepal’s Roadmap to End TB

To achieve the 2035 End TB targets, Nepal must address its challenges head-on. The NTCC recommends the following actions:

Increase Funding: Bridge the 43% funding gap to ensure uninterrupted TB services.
Enhance Case Detection: Leverage AI-driven tools like digital chest X-rays and expand GeneXpert testing.
Community Mobilization: Engage local leaders, schools, and workplaces to raise awareness and reduce stigma.
Strengthen Partnerships: Collaborate with private sectors to improve TB diagnosis and management.
Focus on High-Risk Groups: Prioritize the elderly (23% of cases), children (6%), and impoverished communities (68%).

A Collective Effort to End TB

Nepal’s journey to end TB is a testament to its resilience and commitment. The treatment success rate for DS-TB is 92%. The country has also achieved significant reductions in TB incidence and mortality. As a result, the country is on the right track. However, the 40% gap in case detection and the rising burden of DR-TB underscore the need for urgent action. As we mark World TB Day 2025, let’s rally behind the theme “Yes! We Can End TB: Commit, Invest, Deliver!” and work together to make Nepal TB-free.