India is critical to the global fight to end an epidemic of tuberculosis by 2030 and must step up funding to control the disease, the World Health Organization said, citing concerns over broader cutbacks in government health programs.
India is the world's TB hotspot as it accounts for 23 percent of global cases and the most deaths - 220,000 last year - from the bacterial lung disease that spreads through coughs and sneezes.
Campaigners blame the deaths on weak infection controls, poor oversight and low healthspending. Still, India's TB program reduced the prevalence of the disease by more than half to 211 cases per 100,000 people from 1990 to 2013.
"India is a positive, successful story up to a certain point. From now on, that positive story won't be sufficient and they'll need to do more," Mario Raviglione, director of the WHO's TB program, said in a telephone interview from Geneva.
"When you have a government that cut money to health, you cannot be satisfied. This is a major gap that has to be fixed."
Indian Prime Minister Narendra Modi has been facing criticism for keeping a tight leash on social outlays - the government last year cut the federal health budget by 20 percent citing underutilization of funds.
An internal assessment report in July showed India's TB program was off track due to funding problems - New Delhi approved $243 million for TB control during 2012-2015, lower than the requested $432 million.
A health ministry official denied current shortages, but said the government is assessing how much additional funding would be needed to achieve the 2030 TB target, which he said was ambitious.
Other countries facing significant tuberculosis risk include Indonesia and China.
Combating TB is a daunting task in India due to widespread insanitary conditions, poverty and a lack of public hospitals. Low public awareness and social stigma attached to the killer disease also hinder eradication efforts.
India also needs to upgrade laboratories to better detect the disease - the government last year tracked down 25,000 of the WHO's estimated 47,000 multi-drug resistant TB cases that, Raviglione said, was "not sufficient" but better than before.
TB killed 1.1 million people globally last year, for the first time rivaling HIV/AIDS as a leading cause of death from infectious diseases.
"If India doesn't invest on TB, then there will be very little progress at the global level," said Raviglione.