Tuberculosis (TB) remains the deadliest infectious disease in high-burden countries, despite being preventable and curable. In 2023, TB infected 10.8 million people and caused 1.25 million deaths worldwide. Alarmingly, hidden TB is a big problem. Nearly one-third of Tuberculosis cases go undetected each year, with significantly higher rates of missed cases in countries across the Global South.
Now, innovative approaches in the Philippines and India are turning the tide, bringing TB care to those who had been left behind by public health systems.
Revolutionary Change in the Philippines
In the isolated Bantayan islets of Cebu, Philippines, TB care was once inaccessible to many. The area, comprising 25 barangays, is geographically isolated and underserved, with most residents earning just $6-7 per day as fisherfolk or farmers. Prior to the pandemic, only 39% of estimated TB cases were detected here.
That changed in 2022 with the introduction of cutting-edge diagnostic tools like ultraportable X-ray machines and Truenat molecular tests through a partnership involving the Stop TB Partnership, USAID, and FHI360. These battery-operated tools, designed for use in remote areas, allowed health workers to screen and diagnose TB patients on-site.
Municipal Health Officer Dr. Samantha Tinsay leads the effort, navigating rough seas and inclement weather on pump boats to reach remote communities. Her team’s impact has been transformative, increasing the number of screenings from 187 in 2019 to 5,679 in 2024. Detection rates have skyrocketed, with 99% of estimated TB cases now found and treated.
“TB treatment success rate has also increased to 97% in 2023,” said Dr. Tinsay, a significant improvement compared to the national average of 78%. Her team doesn’t stop at TB care; they deliver a range of services, from HIV and hepatitis testing to mental health support, ensuring holistic care for underserved populations.
Targeting Marginalized Communities in India
In India, the battle against TB is equally intense. Marginalized populations, including homeless individuals and migrants, face increased risks due to poor living conditions, stigma, and lack of access to healthcare. Despite living near major metropolitan healthcare facilities, many slip through the cracks.
Humana People to People India developed the LEAD (Leveraging, Engaging, Advocating for Disruption of TB transmission) initiative, supported by USAID and India’s National TB Elimination Programme. The program trains healthcare workers to connect these populations with public and private healthcare services, providing diagnostics, treatment, and social support.
“During the last year, we have reached out to more than 150,000 people,” said Lisbeth Aarup, Program Head at Humana People to People India. The program has successfully minimized treatment dropouts and introduced AI-assisted TB screening apps, ensuring early detection.
LEAD also focuses on empowering TB survivors to raise awareness and support others through treatment, creating a ripple effect in the fight against TB.
The Path Forward: Scaling Proven Solutions
The success of these initiatives underscores the potential for change. Dr. Tinsay’s work in the Philippines and Humana’s LEAD model in India prove that targeted, people-centered interventions can uncover hidden TB cases, ensure timely treatment, and save lives.
To end TB globally, governments must scale up such programs. This includes replacing outdated diagnostic methods with WHO-recommended molecular tests, integrating additional healthcare services, and focusing on marginalized communities.
The fight against hidden TB requires sustained commitment, but as these efforts demonstrate, transformative change is within reach.
