India's TB elimination effort is said to have evolved from a health programme into a *Jan Andolan*. Critically examine the role of community and youth participation, with reference to initiatives such as Ni-kshay Mitra and JOSH Teams.

India has about one-fourth (26%) of the world's TB cases [7]. The PM TB Mukt Bharat Abhiyaan (2022) [2] and the JOSH (Joint Squad for Health) Teams (2026) [1] are built on Jan Bhagidari, the idea that the government alone cannot end TB. Community participation has widened the campaign's reach. Its impact, however, depends on public systems that back it up.

Role and strengths of participation

• Ni-kshay Mitra: 6,77,541 supporters enrolled and over 45 lakh food baskets distributed [3]. It channels CSR and charitable money into nutrition, a key driver of TB.
• JOSH Teams: youth volunteers mobilised through MoHFW, the Ministry of Youth Affairs & Sports and the Ministry of Defence carry messages on prevention, testing and hygiene [1].
• Fighting stigma: young people as messengers present TB as "preventable and curable", which builds trust in the community [1].
• Active case finding: the 100-day campaign in 347 districts screened over 20 crore people and found about 9 lakh asymptomatic cases [4].
• Results: incidence fell 21% (12% globally), and treatment coverage is 92% (78% globally) [1].

Limitations

• Testing must keep up with demand: volunteers bring people in, but AI-assisted X-ray and molecular testing capacity must match [1].
• Private-sector blind spot: in 2016 about 1 million cases were "missing" from official records, mostly patients treated privately [6]. Awareness campaigns cannot make private doctors report cases.
• Charity, not entitlement: Ni-kshay Mitra support is voluntary and uneven across districts. About 12 lakh of roughly 25 lakh patients a year are underweight [5].
• No way to measure JOSH: the launch did not set volunteer numbers, a budget or targets [1].
• Missed deadline: India's 2025 elimination target [2] has passed. Mobilisation cannot replace delivery [1].

Way forward

• Track JOSH referrals, diagnoses and completed treatments on Ni-kshay, district by district.
• Use volunteers to link private clinics to case reporting [6].
• Build up testing capacity before mobilisation drives.
• Help families claim Ni-kshay Poshan (₹1,000/month) [5].

Ni-kshay Mitra and JOSH have turned TB control into a shared effort against stigma and hunger. Their value will last only if public support remains guaranteed: assured testing, reporting by private providers and cash support as a right, with volunteers adding to the public system rather than standing in for it. If that holds, the Jan Andolan can move India towards SDG 3.3.