Nutritional support is as important as drugs in TB control. Evaluate Ni-kshay Poshan Yojana and the Ni-kshay Mitra initiative in this light.

Undernutrition causes more new TB cases than any other single risk factor. WHO attributes about 0.97 million new cases in 2024 to it, more than to diabetes, HIV or smoking [2]. Drugs cure the infection, but food stops people falling ill and helps them finish treatment. India's two nutrition measures do this only in part.

Why nutrition matters as much as drugs

• Prevention: In the RATIONS trial in Jharkhand, household contacts who received food baskets had about 39% fewer TB cases [3].
• Adherence: About half of TB-affected households worldwide face catastrophic costs, meaning over 20% of household income [4]. Hungry patients are more likely to stop treatment early.

Ni-kshay Poshan Yojana (NPY): Strengths

• Cash goes straight to patients through DBT, which cuts out leakage. Over ₹3,202 crore has reached 1.13 crore beneficiaries [1].
• The amount was raised from ₹500 to ₹1,000 a month. Energy-dense supplements go to patients with BMI below 18.5 in the first two months of treatment [1].

NPY: Limitations

• ₹1,000 is small against lost wages for the patient and the caregiver [1][4].
• It covers patients only, not household contacts, who are the group RATIONS showed can be protected [3].

Ni-kshay Mitra: Strengths

• It is described as the world's largest crowd-sourced nutrition programme for TB patients. CSR funds and citizens adopt patients for at least 6 months, and support now reaches household contacts [1].
• It builds a Jan Andolan (people's movement) and reduces stigma.

Ni-kshay Mitra: Limitations

• It is voluntary. Coverage depends on where donors are and how willing they are, so it is not an entitlement families can claim.
• Food baskets vary in quality, and support can end after six months.

Verdict: NPY gives a dependable but small base. Ni-kshay Mitra adds reach but uncertain coverage. Together they treat nutrition as an add-on, not as a core part of treatment.

Both schemes rightly treat food as part of TB care, but neither yet matches the weight of the evidence. Benefits under NPY could be linked to inflation, and budgeted food support for contacts could be modelled on RATIONS. Ni-kshay Mitra would then add to state support rather than replace it. This would treat nutrition as an entitlement, in line with Article 47 and SDG 3.3, and bring the goal of TB Mukt Bharat within reach.