World Tuberculosis (TB) Day stands as a poignant reminder, not just of the global challenge that TB continues to pose, but of the profound human stories that unfold within its shadow.

Beyond the statistics—10.6 million people worldwide fell ill with TB in 2023 (WHO)¹, and India, bearing the highest burden, accounted for a quarter of those cases (as per Global Tuberculosis Report of WHO)¹—there are the untold stories of struggle, perseverance, and the quiet strength of individuals and communities. TB is not just a disease of the body; it is a disease of the mind, of stigma, of isolation, and of misunderstanding. For many, the fear of judgment and the daunting nature of prolonged treatment are as crippling as the disease itself. As we commemorate World TB Day, while we focus on eliminating the disease, efforts should also be directed towards dismantling the stigma that surrounds it.

At ECHO India, we recognize that the fight against TB is not just about antibiotics or medical protocols, it is about education, empathy, and empowerment. It is about standing alongside every individual affected by TB, providing them with not just a cure, but with a sense of dignity, hope, and support. While our work touches every aspect of TB management, we focus on professional training and capacity building of healthcare professionals so that they can function in a better manner, and truly be the support that the TB patient needs. We are completely aligned with the concept of “TB free India” as envisioned by the union government. We are committed to creating a world where TB is not feared but understood, where patients are not abandoned but supported, and where the global community is united in the pursuit of a TB-free future.

The TB Challenge: A Disease of the Body and Beyond

TB is a disease that does not discriminate. It knows no borders, no economic barriers, no caste or creed. According to the National TB Elimination Program (NTEP), India accounts for over a quarter of the world’s TB cases, a staggering number that underscores the urgent need for action². However, the disease is not just a biological threat, it is also a social one. TB remains one of the most stigmatized diseases in India, largely due to the myths and misconceptions that surround it. This stigma leads to delays in seeking treatment, of improper treatment leading to emergence of drug resistant TB, a lack of adherence to prescribed regimens, and, tragically, increased transmission rates.

As we face the complexities of TB, we must remember that the battle is not only against the bacteria but also against the societal structures that allow this disease to thrive in silence. A significant challenge is ensuring that patients continue their treatment, often for months or even years. It is easy to start the journey, but it is far harder to stay on it. That’s where the role of TB champions, those who are affected by TB but have not only conquered the disease themselves but are now actively helping others, becomes critical. These champions stand at the heart of our strategy, embodying resilience, perseverance, and hope. They are the ones who encourage their fellow patients to keep going, to continue their treatment without faltering, to understand that the end of TB is not just a physical recovery but a victory over stigma and fear.

A Holistic, Human-Centered Strategy

Ideally, TB management should span every aspect of the disease, from prevention and detection to treatment, care, ensuring adequate nutrition of TB patient, and even the respectful and safe handling of deceased individuals. Addressing every step in the TB continuum, starting with the awareness and prevention strategies that help stop the disease before it spreads, moving through accurate diagnosis and effective treatment, and ensuring dignified management at the end of life for those who do not survive is critical for eliminating TB. This approach is holistic, bridging clinical expertise, community engagement, and cultural sensitivity to ensure that TB care is comprehensive, compassionate, and culturally appropriate. ECHO India does all of this by training and capacity building of HCPs (healthcare providers), empowering them to perform and deliver at their best in this fight against TB. And we are very proud of the fact that we do this in collaboration with the Union and State Governments, in complete alignment with the national policy and goals.

The ECHO model has now officially become a part of the National Tuberculosis Elimination Program (NTEP) as the model and vehicle of choice for the upskilling of the workforce across all aspects of TB management. As an initiative to strengthen State TB Training and Demonstration Centers (STDCs) and enable them to perform their functions more efficiently, ECHO hubs have been established at these centers. STDCs are now expected to use these hubs to improve program efficiency and build workforce capacity. Special guidance has been provided to STDCs for designing their virtual capacity-building programs and effectively utilizing virtual knowledge hubs. For example, STDCs have the flexibility to implement advanced courses beyond regular training, addressing specific state needs, such as soft skills, communication, leadership, management, operations research, or financial management, tailored to improve workforce efficiency as an ECHO program³.

ECHO India’s collaboration with Nodal DR-TB Centers across Rajasthan exemplifies the integration of the ECHO model within NTEP, decentralizing care for drug-resistant TB (DR-TB) and empowering healthcare workers at the local level. In Ajmer, Jawahar Lal Nehru Medical College introduced its first ECHO capacity-building program, mentoring healthcare providers from districts like Ajmer, Nagaur, Bhilwara, and Tonk. These programs ensure that even the most challenging TB cases are addressed with the most up-to-date knowledge and practices.

In addition, our efforts have had a significant impact in the remote regions of Jammu and Kashmir, where ECHO India’s partnership with the State TB Cell in the CATCH TB project (Collaborative Action for TB control and Community Health Officers) is transforming TB care in Baramulla and Kupwara. Mid-Level Health Providers (MLHPs) and community healthcare workers (CHWs) are bridging gaps in diagnosis and treatment through NIKSHAY Diwas events and door-to-door screening programs. This localized approach ensures that TB care is accessible, even in the most isolated areas.

We would also like to acknowledge our invaluable partners, NITRD (National Institute for Research in Tuberculosis), NACO (National AIDS Control Organization), CTD (Central TB Division) and CDC India, whose collaboration has been essential in advancing the care for co-infected HIV-TB patients. The e-NISCHIT program, launched in 2018 as a partnership between the abovementioned, and ECHO India, has significantly strengthened the ability of healthcare workers to manage both TB and HIV co-infection. Over 200 healthcare professionals have participated in the e-learning sessions, deepening their understanding and creating a unified network of support for both diseases.

Furthering our collaboration, NACO has been a critical ally in helping strengthen the integration of HIV and TB care. Together, with NITRD, we are working to bridge the gap in the diagnosis and management of co-infection cases, which often present challenges in terms of treatment adherence and patient care.

Conclusion

On this World TB Day, we remind ourself that the fight against TB is not just about early detection, prompt and effective treatment and preventing the spread of a disease, it is also about ending the stigma, overseeing treatment adherence, and ensuring that every individual has access to the care and support they need. Through collaboration, education, and continuous support, we can create a world where TB no longer holds people in fear or isolation, but where it is met with compassion, resilience, and the knowledge that it can be overcome. At ECHO India, we are proud to be part of this movement, working every day to ensure that TB care is not just a medical intervention but a human-centered, community-driven, and stigma-free journey.

Together, we can end TB, not just as a disease, but as a barrier to hope and healing.

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