In close collaboration with national and local partners, The Union is leading two initiatives designed to accelerate the elimination of tuberculosis (TB) in urban settings across the states of Telangana and Delhi.
These pioneering projects focus on the implementation of population-wide screening – an intervention The Union is the leading advocate for.
TB Free Urban Slums of Delhi
Delhi carries one of the highest TB burdens in India, with a TB prevalence rate of 747 per 100,000 population. An estimated 61% of people have been infected with TB bacteria at some point – most without symptoms, but still at risk of developing the disease.
Urban slum communities are especially vulnerable – limited healthcare access makes it significantly easier for TB to spread, persist, and go undetected.
Kavita, TB survivor, said: “For a month, my body was trying to tell me something, but I chose not to listen. When I heard about a nearby TB screening camp, I finally went. One X-ray changed everything – I was diagnosed with TB.
“Today I stand here stronger, knowing TB is not something to fear – it is something to treat.”
Addressing this challenge is further complicated by Delhi's overlapping health systems and administrative structures, making coordinated TB control historically difficult.
To address this challenge, The Union – in collaboration with the Central TB Division (Ministry of Health and Family Welfare, Government of India), the Delhi State Government, and the State TB Programme – launched a population-wide screening initiative across urban slums in six districts of Delhi.
The project has deployed 21 handheld X-ray devices that are directly linked to the healthcare database.
Kisan, School Principal and community leader, said: “When I learned about the TB screening camps, I didn’t see it as just another programme – I saw it as a responsibility.
“Our community lives in challenging conditions, where access to timely healthcare is not always easy. So, when the opportunity came, we opened our school to host the screening camps. For us, this was never just about offering a venue – It was about standing with our community in a shared fight against TB.”
Since mid-2025, the project has screened over 160,000 people across these six districts, identifying more than 800 people with TB and linking them to treatment.
Dr Jyoti Jaju, Programme Director at The Union, said: “Ending TB demands that we move earlier, reach deeper, and act with greater precision – and this is exactly what this effort is enabling. By identifying people before the disease can take hold or spread further, we are not just improving diagnosis, we are changing trajectories for individuals, families, and entire communities.
“It shows what becomes possible when innovation is translated into action on the ground, and when systems align – to move faster, reach further, and bring us meaningfully closer to ending TB.”
Swasthya Nagaram in Telangana
This three-year initiative is being delivered with urban local bodies (municipal corporations of Peerzadiguda, Boduppal and Pocharam), and support from the National TB Elimination Programme and State of Telangana.
While implementing population-wide screening, various tools and models for screening will be evaluated as a pragmatic randomised controlled trial. The evaluation will focus on identifying the most cost-effective population-wide screening approach for urban areas.
Two key methods being assessed are the use of artificial intelligence (AI) enabled ultra-portable chest X-ray machines with computer-aided detection, and low-cost, near-point-of-care diagnostic tests.
Other tools that will also be evaluated, including targeted screening of vulnerable groups, AI-powered cough analysis, and sample collection transportation systems.
Ankur Sharma, Junior Field Officer at The Union, said: “I am on the ground organising X-ray screening camps – because early detection is critical. But detection alone isn’t enough. The real challenge we face every day is stigma... we counsel families, run awareness sessions, and work to replace fear with facts.
“Every person we reach and every family we support brings us one step closer to a TB-free India.”
Swasthya Nagaram, supported by the Gates Foundation, will cover 250,000 people living across the three urban areas, during the three annual rounds of screening. Participant recruitment began in November 2025 and is expected to complete by mid-2028.