Evaluate the role of community participation and nutritional support in improving TB treatment outcomes in India.

Tuberculosis is a disease of poverty. Undernutrition weakens patients, and stigma pushes them to drop out of treatment. WHO's Global TB Report 2026 shows India's TB mortality rate falling from 28 to 18 per lakh (2015–2025), a 38% fall against 35% globally. Treatment success for drug-susceptible TB stands at 94%, and the report credits nutritional and community support among the drivers [1]. Both have clearly improved outcomes, but gaps in delivery limit how much they achieve.

Nutritional support: role

• Ni-kshay Poshan Yojana (2018): pays ₹1,000/month by DBT through the Ni-kshay portal for the full course of treatment [2].
• Scale: ₹4,454.68 crore has been paid to 1.38 crore beneficiaries [2].
• Outcome link: it tackles the undernutrition that lowers immunity and drives dropout, and DBT reduces leakage [1][2].

Community participation: role

• PMTBMBA and Ni-kshay Mitra (2022): 6,77,541 Ni-kshay Mitras and over 2 lakh MY Bharat volunteers support patients [2].
• Jan Andolan: over 30,000 elected representatives are involved, and JOSH Teams bring in NCC cadets [1][2].
• Active case finding: 14.97 lakh of the 48.64 lakh cases detected (about 31%) had no symptoms. These patients would never have come to a clinic [1].
• Local accountability: 67,933 Panchayats were certified TB-free for 2025 [1].
• Result: treatment success under the Abhiyaan is 90%, against a global average of 88% [2].

Limitations

• Narrow denominator: success rates count only notified patients. People treated privately and never reported are left out.
• Timeliness unmeasured: NPY data show the total amount paid, not whether the cash reached patients in the early, high-risk months of treatment.
• Weak oversight: CAG found District DR-TB Committees were not formed or were formed late in Delhi [3].
• Perverse incentive: if "TB-free" status depends on few reported cases, a Panchayat gains nothing by finding hidden cases.
• Distance to goal: incidence was still 187 per lakh in 2024, and the 2025 elimination goal was missed [2].

Overall, nutritional support and community participation have made TB control a people-led effort and have measurably improved treatment success. To build on this, Ni-kshay should track how quickly NPY payments reach patients, TB-free certification should be tied to screening coverage, and DR-TB committees should be made functional. Done together, these steps can turn India's faster-than-global progress into elimination in line with SDG 3.3 by 2030.