(MENAFN- Live Mint)

New Delhi: India is working to standardize the nutritional support for tuberculosis (TB) patients and their family members through a regional food basket, according to the two officials and documents reviewed by Mint.

The budget for combating TB is ₹3,259.26 crore in the 2025-26 financial year.

This enhanced focus on nutrition comes in the backdrop of India's high TB burden, which accounted for the highest number of cases globally in 2024, with over 2.6 million patients diagnosed that year. The basket intentionally relies on locally available, affordable, high-protein foods such as pulses, soya chunks, roasted peanuts, chana, and local seeds.

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For instance, Western region's food basket comprises locally favoured items such as jowar, bajra, whereas the Eastern region's basket specifies parboiled rice and masoor. In comparison, the Southern region basket calls for the use of peanuts and Bengal gram, and the North's has wheat and mustard oil.

Addressing nutrition is a vital component of the TB treatment playbook, given that undernutrition increases TB risk, with evidence suggesting that a proper diet improves treatment adherence, reduces mortality, and enhances long-term outcomes. The Union health and family welfare ministry has asked all states and Union territories to adopt this food basket as a reference for equity, consistency, and nutritional adequacy, while allowing for flexibility based on regional food diversity.

In a communication, seen by Mint, Prof. (Dr.) Urvashi B. Singh, deputy director general (DDG) of the Central TB Division (CTD), has directed all states and Union territories to adopt a revised nutritional food basket as the reference for the Ni-kshay Mitra initiative, with certain flexibility referring to regional food diversity.

Better nutrition

Nutritional support to persons with TB and their family members/household contacts is a vital component of the Ni-kshay Mitra initiative, Dr Singh said.“Undernutrition, and TB share a bidirectional relationship: undernutrition increases the risk of developing TB, while TB worsens nutritional status due to increased tissue breakdown. Evidence suggests that addressing undernutrition improves treatment adherence, reduces mortality, and enhances long-term outcomes in TB care," she said.

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“This standardization will support equity, consistency, and nutritional adequacy across the country. These measures are expected to significantly enhance nutritional sustainability and treatment outcomes for TB-affected individuals," she added.

Queries sent to the health ministry remained unanswered til press time.

Dr Soumya Swaminathan, principal advisor for the national TB elimination programme, said that the Ni-kshay Mitra programme has been significantly expanded to include the family members of tuberculosis patients.“This expansion is crucial because the family members are often undernourished and are at a high risk of acquiring the TB infection due to their close contact with the patient. The government has therefore extended nutritional support not only to the TB patients themselves but also to the entire household where adequate nutrition is essential," she said.

Swaminathan, who was earlier WHO's chief scientist, added that the additional guidance provided by the ministry is particularly useful because there is no need to spend money on commercial, hyped-up products, which are often expensive and may contain excessive sugar.“The latest standardized regional diet developed by the ministry caters to a nutritional diet for the TB patient with local preferences and availability," she said.

Local food

Earlier, Mint reported the DCGI rejected emergency authorization for Serum Institute's recombinant BCG (rBCG) vaccine (VPM1002) for those aged six and older, citing "not adequate and conclusive" data. The regulatory body recommended submitting further safety and immunogenicity data. This decision underscores the urgent need for a more effective vaccine, as the existing BCG vaccine gives limited protection against pulmonary TB, and its efficacy wanes significantly beyond early childhood.

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The Ni-kshay Mitra food basket, totalling 18 kg and 81,000 kcal for patients with TB and boosts immunity for high-risk family contacts. It relies on affordable, local protein (4.5 kg pulses, 4.5 kg protein foods) instead of expensive supplements, meeting the high protein demands essential for TB recovery and tissue repair.

“India's step to develop region-specific, protein-rich food baskets for TB patients is crucial for strengthening treatment outcomes," said Shruti K. Bhardwaj, chief clinical nutritionist, Zydus Hospitals, Thaltej Ahmedabad. "This initiative respects local food diversity while ensuring equity and cultural relevance. Undernutrition is a strong risk factor for TB, and improving dietary intake boosts immunity and recovery rates. Leveraging affordable, local foods like pulses and regional oils makes the programme practical and sustainable."

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