Tuberculosis in India is far more than a medical diagnosis; it is a disease shaped by stigma, delayed care, poverty and gaps in support. As World TB Day 2026 reminds us with the theme “Yes! We can End TB- Led by countries, powered by people,” Dr. Nikhil Mathur, Chief of Medical Services, CARE Hospitals, argues that real progress will depend not just on better drugs and policies, but on how early patients seek help, how steadily they can stay on treatment, and how willing society is to stand with them through the long journey to cure.
Over the years, tuberculosis has never been treated like any other infectious disease in my clinical practice. It is intricately linked to systemic gaps that extend beyond medicine, delayed health-seeking behavior and social realities. The theme for World TB Day 2026, “Yes! We can End TB- Led by countries, powered by people,” reflects a reality I witness every day in hospitals, the fight against tuberculosis is not just about government initiatives or medical professionals, it also depends on how early patients come forward, how consistently they adhere to treatment, and how society reacts to them.
Although India has achieved considerable strides in the fight against tuberculosis, the illness still manifests itself in alarming ways. Many patients still arrive late to our hospitals, frequently after weeks or even months with symptoms like fever, weight loss, or a persistent cough. The illness has advanced considerably by the time they get to us. The reasons for the delay, fear, denial, and stigma stand out as much as the delay itself.
Many patients, especially from working-class backgrounds, initially ignore symptoms because they cannot afford to lose daily wages. Others avoid testing due to the stigma associated with TB, worried about how it may affect their family or employment. In some cases, patients move between multiple informal or unqualified providers before reaching a structured healthcare setting. These patterns continue to fuel transmission and complicate treatment outcomes.
At the same time, I must acknowledge that the ground reality today is far better than it was a decade ago. Access to rapid diagnostics such as molecular testing has improved significantly, allowing us to confirm TB much earlier than before. Free treatment programs and nutritional support initiatives have reduced some of the financial burden on patients. Digital tools are also helping in tracking adherence and ensuring follow-ups.
However, the gap is not in policy, it is in last-mile implementation and patient behaviour. Awareness is still uneven, especially in semi-urban and rural populations. Even in cities, TB is often not the first condition people suspect when symptoms begin. This delay in recognition is something we need to address more aggressively.
One of the most complex challenges we face today is drug-resistant TB. These patients require longer, more intensive treatment regimens that come with significant side effects. In my experience, adherence becomes a major issue, not because patients are unwilling, but because the treatment journey is physically and emotionally exhausting. Nausea, fatigue, and psychological stress often lead patients to discontinue therapy midway.
In our own experience, one of the biggest barriers to successful TB treatment is not access to medicines, but the patient’s ability to sustain recovery over several months. Many patients are nutritionally compromised and socially vulnerable. To address this, we recently initiated Project OJAS, a collaborative effort with the district administration and civil society partners, focused on providing nutritional and psychosocial support to TB patients. What we are seeing on the ground is clear: when patients receive structured support beyond medication, their ability to adhere to treatment improves significantly, and so do outcomes.
This is where TB management needs to evolve beyond prescriptions. Counselling, mental health support, and family involvement are critical. We have seen better outcomes when patients are closely supported, not just medically, but socially and emotionally. TB cannot be treated in isolation from the patient’s life circumstances.
Another area that needs stronger attention is the role of frontline healthcare providers. Primary care doctors, community health workers, and even local pharmacists are often the first point of contact. Their ability to identify symptoms early and guide patients into the right treatment pathway can make a decisive difference. Similarly, private practitioners must be fully integrated into the national TB framework, particularly in terms of case notification and standardized treatment protocols.
It is also the duty of hospitals and diagnostic facilities to work more closely with public health programs. In our experience, stronger coordination between private hospitals and government systems leads to better patient tracking, improved adherence, and continuity of care. This is an area where we still have significant potential to improve.
As we reflect on this year’s theme, my message is simple and direct.
To individuals and families, do not ignore symptoms like a persistent cough or unexplained weight loss. TB is treatable and curable, but only if diagnosed early.
To policymakers, continue strengthening awareness at the grassroots level and ensure that support systems reach the patient, not just exist on paper.
To healthcare providers, whether in public or private practice, we must work as one system. TB control cannot succeed in silos.
Ending TB in India is not an unrealistic goal. But it will require us to move beyond programs and protocols, and focus on people, their realities, their challenges, and their ability to stay the course. Only then can we truly say: yes, we can end TB.
