The WHO highlighted that, alongside new drugs and technologies, addressing undernutrition must be a central part of TB control strategies to reduce mortality and accelerate progress towards ending the epidemic.
Published Aug 12, 2025 | 7:00 AM ⚊ Updated Aug 12, 2025 | 7:00 AM
Tuberculosis. (iStock)
Synopsis: The WHO has recognised an Indian study for demonstrating how nutritional support can dramatically improve tuberculosis treatment outcomes. The study evaluated the impact of providing targeted nutritional assistance to patients, highlighting the importance of integrating nutrition into comprehensive TB care.
The World Health Organisation (WHO) has recognised an Indian study for demonstrating how nutritional support can dramatically improve tuberculosis (TB) treatment outcomes.
The study, titled Nutritional support for adult patients with microbiologically confirmed pulmonary tuberculosis: outcomes in a programmatic cohort nested within the RATIONS trial in Jharkhand, India, was led by Professor Anurag Bhargav and published in The Lancet.
This evidence from India’s RATIONS trial, a field-based, cluster-randomised controlled study, is now shaping global guidance on combating TB, the world’s deadliest infectious disease. The WHO calls for increased innovation and research to meet ambitious elimination targets.
TB disproportionately affects vulnerable populations, especially in South-East Asia, where nearly five million people fell ill with the disease in 2023 alone.
The WHO highlighted that, alongside new drugs and technologies, addressing undernutrition must be a central part of TB control strategies to reduce mortality and accelerate progress towards ending the epidemic.
The research, conducted in high-burden settings, shed new light on the crucial role nutritional support plays in improving treatment success and reducing mortality among adults diagnosed with pulmonary tuberculosis.
The study evaluated the impact of providing targeted nutritional assistance to patients, highlighting the importance of integrating nutrition into comprehensive TB care.
Tuberculosis remains a significant global health challenge, with India bearing a disproportionate share of the burden. Despite ongoing efforts to reduce its incidence and mortality, progress has been hindered by factors such as undernutrition, which frequently coexists with the disease and worsens patient outcomes.
Enrolling 2,800 adults with confirmed pulmonary TB, the study provided nutritional support, including daily food rations with 1,200 kcal and 52 grams of protein, as well as micronutrients. The intervention lasted six months for drug-susceptible TB and up to 12 months for multidrug-resistant cases.
The study mentioned, “Weight gain, particularly in the first two months, was associated with a substantially decreased hazard of tuberculosis mortality.”
With over 82 percent of patients underweight at baseline, the trial achieved a 93.7 percent treatment success rate and reduced TB deaths to just 3.9 percent. A five percent weight gain in the early treatment phase cut the risk of death by 61 percent, showcasing nutrition as a critical, yet often overlooked, pillar of TB care.
In the course of their research, the researchers delivered targeted nutritional support to a group of patients characterised by widespread and severe undernutrition in the State.
The outcomes of this intervention proved promising, and notable improvements in treatment success and a significant reduction in tuberculosis-related mortality. These findings underscore the critical importance of addressing nutritional deficiencies as a fundamental element of effective tuberculosis management.
Building on the RATIONS trial findings, the WHO urged South-East Asian countries to urgently scale up research and innovation. Dr. Catharina Boehme, Officer-in-Charge of WHO South-East Asia Region, stressed that achieving the ambitious targets of the WHO End TB Strategy requires collaboration to accelerate research and innovation, and ensuring timely and equitable access to these innovations is critical.
She added that nearly five million people in the South-East region were diagnosed with tuberculosis in 2023, with close to 600,000 succumbing to the disease.
Despite progress such as increased case notifications post-COVID-19, the WHO noted persistent challenges, including rising drug-resistant TB and uneven application of research outcomes.
New digital tools, AI-driven diagnostics, and social support mechanisms like direct benefit transfers are being deployed, but gaps remain in knowledge-sharing and access.
The WHO’s statement underscores that equitable nutrition support, alongside new drugs and diagnostics, is essential to “leave no one behind” in the fight against TB. India’s RATIONS study provides a model for how integrating nutrition into TB programs can save lives and transform global TB care strategies.
(Edited by Muhammed Fazil.)
