Inter-ministerial convergence is key to achieving health outcomes. Discuss with reference to initiatives such as JOSH Teams and the TB Mukt Bharat Abhiyaan.

Health outcomes depend on nutrition, income, awareness and community mobilisation, and most of these lie outside the Health Ministry's mandate. India leads the list of eight countries that carry two-thirds of the world's TB burden [3]. Its shift to a whole-of-government, whole-of-society model shows how convergence works in practice.

Convergence in practice

• TB Mukt Bharat Abhiyaan (2022): a Jan Andolan (people's movement) under NTEP. Its 100-Day campaign (December 2024) brought in 24 line ministries and 30,000+ elected representatives [2].
• JOSH Teams (2026): MoHFW provides the TB framework, MoYAS supplies MY Bharat volunteers and MoD supplies NCC cadets. Class-I officers lead the teams at Block/Ward level, and Phase I covers 55 districts in 11 States [1].
• Nutrition–health link: Ni-kshay Poshan Yojana pays ₹1,000/month by DBT. Over 2 lakh MY Bharat volunteers already serve as Ni-kshay Mitras [2].
• Local governance: 67,933 Panchayats in 697 districts were recognised as TB Mukt in 2025 [1].

Outcomes achieved

• Incidence fell 21% (237 to 187 per lakh, 2015–24), and treatment success reached 90%, above the 88% global average [2].
• Active case-finding diagnosed 28+ lakh patients, about 9 lakh of them asymptomatic [2]. Such patients rarely come to clinics on their own.

Limits of convergence

• Awareness is not support: about 50% of TB-affected households face catastrophic costs, and undernutrition is the largest risk factor [3]. JOSH's mandate covers only messaging [1].
• Federal capacity: health is a State subject. Referrals are wasted if State testing and drug supply cannot keep up.
• Diffused accountability: activity counts can replace outcome measures. The national 2025 elimination goal [2] has passed with TB still widespread.

Way forward

• Pair every JOSH team with a Ni-kshay Mitra and a DBT linkage.
• Track referrals and treatment completion on a shared dashboard, not the number of events held.
• Evaluate Phase I before scaling up nationally, as was done with the 100-Day campaign [2].

JOSH and the Abhiyaan show that pooling the manpower and reach of several ministries can turn a medical programme into a people's movement. If this convergence is tied to shared outcome targets and nutrition support, it can deliver SDG 3.3 by 2030 and fulfil the Article 47 duty to improve nutrition and public health.