Undernutrition is the single greatest modifiable risk factor for tuberculosis (TB), contributing to immune suppression, treatment failure, and death. Despite this, nutritional support has not traditionally been a part of standard TB treatment. Researchers from Boston University (BU) and Boston Medical Center (BMC), in close collaboration with India's National Tuberculosis Elimination Programme (NTEP), found that providing food baskets to people with TB and their households may not only be cost-effective, but may also save tens of thousands of lives annually in India if implemented at scale.
"Undernutrition isn't just a complication of TB—it's one of its root causes," said Urvashi Singh, MD, former Deputy Director General of the NTEP. "While we wait for effective vaccines for TB, food is the vaccine we already have, and providing food baskets to households affected by TB could be one of the most impactful things we do for TB elimination."
The researchers found that for every 10,000 patients, food supplementation was estimated to prevent 10,470 years of poor health or early death. It would cost an estimated $141 to achieve each of these health gains, which is well below India's benchmark of $550 and suggests that the intervention could be a good investment. In fact, in 94% of the study's simulations, food support was found to be a cost-effective way to improve health outcomes for people with TB. When scaled to India's 2.8 million annual TB cases, universal coverage could avert approximately 120,000 TB deaths per year nationwide.
"What this study shows is that scaling up in-kind nutritional support in India isn't just the right thing to do—it's also an excellent investment," said senior author Pranay Sinha, MD, assistant professor of medicine at BU Chobanian & Avedisian School of Medicine and infectious disease physician at BMC. "For less than the cost of many biomedical interventions, we could prevent over 100,000 TB deaths a year."
"This work bridges the gap between clinical evidence and policy," said first author Julia Gallini, a doctoral candidate in biostatistics at BU. "We wanted to give NTEP and global health policymakers a clear, quantitative picture of what nutritional support could achieve nationally. The numbers make a compelling case."
