ICMR Plans To Take TB Fight To Delhi’s Urban Slums

Racing against the 2030 TB-elimination global deadline, the Indian Council of Medical Research (ICMR) is taking the fight into Delhi’s densely populated slums, seeking community partners to detect and treat the contagious disease closer to households and neighbourhoods.

The ICMR has invited Expressions of Interest from eligible non-governmental organisations (NGOs) and community-based organisations (CBOs) to become implementation partners for its proposed ‘Delhi TB Free Slum Demonstration Project’ under the TB Research Accelerator Programme.

The initiative aims to test whether an integrated, community-driven approach can reduce the burden of TB in vulnerable urban populations while working within the existing framework of the National Tuberculosis Elimination Programme (NTEP).

The project comes against the backdrop of persistent challenges in urban TB control. According to the ICMR document, population density, migration, poverty, undernutrition, household crowding and fragmented access to healthcare can contribute to delayed diagnosis, treatment interruptions and difficulties in ensuring continuity of care.

Delhi, with its large migrant population, extensive slum settlements and complex public-private healthcare landscape, has been identified as an important setting for testing new approaches to urban TB control.

The proposed demonstration is expected to cover three sites, with each site catering to an estimated 1.5 lakh to 1.75 lakh people over three years. The eventual geography and operational arrangements will be finalised subsequently.

At the heart of the initiative is a shift from isolated interventions to a population-based continuum of care — beginning with identifying households and vulnerable individuals and extending through screening, diagnosis, treatment support, prevention and follow-up.

Selected NGOs and CBOs will be expected to undertake household-level enumeration and create population registries, including identification of migrant and mobile populations. They will also assess vulnerabilities such as undernutrition, diabetes, previous TB, household exposure and barriers to accessing healthcare, said an official associated with the proposed project.

Community mobilisation will form another critical component. Organisations will facilitate symptom screening, mobile screening activities, chest X-rays, molecular testing, sample collection and referrals, while following up with people suspected of having TB until diagnostic evaluation is completed.

The project also envisages longitudinal community surveillance, allowing field teams to identify people who develop symptoms between formal screening rounds. Periodic household visits, referral tracking and follow-up of symptomatic individuals are expected to form part of this effort.

For people diagnosed with TB, community partners will support treatment continuity through counselling, adherence support and follow-up of treatment interruptions. They may also facilitate access to differentiated support and help identify and refer patients with co-morbidities such as diabetes.

Prevention is another important pillar. NGOs and CBOs will help identify household contacts of TB patients, mobilise them for screening and support eligible individuals through TB preventive treatment, or TPT, in accordance with NTEP guidelines.

The ICMR document places considerable emphasis on community engagement and reduction of stigma, which has remained a major hurdle in eliminating the disease. Organisations will be expected to work with community leaders and local structures, promote awareness and encourage households to participate in screening and treatment services.

The proposed model also seeks to build a digital layer into community-based implementation, with partners supporting digital data collection, monitoring dashboards, implementation records, quality assurance and periodic review.

Importantly, the ICMR has made it clear that community organisations will not replace the formal health system. Diagnostic confirmation, treatment initiation, clinical decisions and programme reporting will remain aligned with established NTEP mechanisms and technical oversight.

The project will work in collaboration with NTEP, the Central TB Division of the Union Health Ministry, Delhi government authorities and local municipal officials.

For people diagnosed with TB, community partners will support treatment continuity through counselling, adherence support and follow-up of treatment interruptions. They may also facilitate access to differentiated support and help identify and refer patients with co-morbidities such as diabetes.

Prevention is another important pillar. NGOs and CBOs will help identify household contacts of TB patients, mobilise them for screening and support eligible individuals through TB preventive treatment, or TPT, in accordance with NTEP guidelines.

The proposed Delhi project thus represents an attempt to shift the TB response from waiting for patients to reach health facilities to actively taking screening, referral and treatment support to the communities themselves.

If the demonstration proves effective, the government plans to scale up this community-centred TB intervention in other high-burden urban settlements too.

Delhi has recorded 1.75 lakh TB notifications under the intensified TB-Mukt Bharat campaign up to July 1, 2026, according to the Union Health Ministry. During the drive, 28.83 lakh people were screened, including 21.67 lakh chest X-rays and 3.65 lakh molecular (NAAT) tests.

A focused screening exercise conducted between March 24 and May 5, 2026, identified 12,078 TB cases in Delhi. This included 10,755 adults and 1,323 children.

Notably, 42% of these 12,078 cases were extrapulmonary TB, indicating infection in organs beyond the lungs.

India had aimed to eliminate tuberculosis in 2025 but missed the target set more than eight years ago. With over 27 lakh new cases every year, it still carries the world’s highest TB burden. According to an estimate, nearly three lakh people die from the disease annually, while about one in 10 patients who complete treatment develop TB again within two years.

The World Health Organization (WHO) aims to end the global tuberculosis (TB) epidemic by 2035 through its The End TB Strategy, aligning with the United Nations Sustainable Development Goal (SDG) target to end the TB epidemic by 2030.