A new modelling study has found that providing monthly food baskets to all 2.8 million people who develop tuberculosis (TB) in India each year could avert more than 1.2 lakh deaths annually, underlining undernutrition as a major but modifiable driver of TB mortality.
The analysis, published in BMJ Global Health and conducted in collaboration with the National Tuberculosis Elimination Programme (NTEP), suggests that such in-kind nutritional support is not only life-saving but also highly cost-effective compared to many biomedical interventions.
According to the researchers, the proposed intervention consists of food baskets for TB-affected households and is estimated to avert around 10,470 disability-adjusted life years (DALYs) per 10,000 people with TB. When scaled up to India’s roughly 2.8 million TB cases annually, this translates to nearly 1,20,120 TB deaths that could be prevented each year if full coverage is achieved, with each health gain costing about USD 141, well below India’s willingness-to-pay benchmark of USD 550, indicating strong value for money.
Experts associated with the study stressed that undernutrition is not just a complication of TB but one of its root causes, significantly weakening immunity, increasing the risk of treatment failure, and raising the likelihood of death. They noted that while India and the world await more effective TB vaccines, food support acts as a “vaccine we already have, with earlier trials such as the RATIONS study showing that improved nutrition among household contacts can cut TB incidence by up to 40–50 per cent and reduce mortality by about 60 per cent through early weight gain.
The findings come at a time when India accounts for the largest share of the global TB burden and has committed to ambitious elimination targets, making social determinants like nutrition central to policy debates. Researchers and public health experts argue that scaling up in-kind nutritional support through NTEP could bridge critical gaps in existing schemes, strengthen treatment adherence, and accelerate progress towards TB elimination, framing nutrition not as welfare spending but as a high-impact public health investment.
