For patients battling tuberculosis (TB) in economically backward regions, financial support from government initiatives is as essential as medication. Delays in the disbursement of this aid are significantly affecting recovery for patients across Andhra Pradesh, as many struggle to afford nutritious food and travel expenses for treatment, as highlighted by Nellore Sravani.
Sandhya, a woman in her 40s, firmly states that she has completed every prescribed dose for her TB treatment. Yet, her frail appearance, as she sits outside her mud house in a remote tribal region near Paderu in Alluri Sitharama Raju district, suggests she is decades older than her actual age.
Her challenges extend far beyond the disease itself. Like countless other TB patients in the state, Sandhya is awaiting crucial financial assistance meant to support her through treatment, illustrating the dire consequences of the delays faced by some of the most vulnerable individuals.
Diagnosed with pulmonary TB in December 2025, Sandhya relies on her elder daughter, who is the sole breadwinner for their family of four, which includes Sandhya and her three children. Sandhya is following a six-month regimen for drug-sensitive TB (DS-TB), involving four different medications. However, her claims of adhering to the treatment are contested by neighbours who report she halted it in the second month due to severe stomach pain.
Despite encouragement from neighbours to seek help at the Primary Health Centre located nearly 10 km away, Sandhya refuses, softly stating, “I cannot make the journey.”
Challenges of Accessibility and Nutrition
Being part of a Particularly Vulnerable Tribal Group (PVTG), accessing nutritious food and seeking medical assistance is a formidable task for Sandhya. The hamlet, which has around 200 residents, is positioned on a hillock, reachable only via a muddy, unpaved road. There are no schools or anganwadis within a 5 km radius, and the nearest shop is 2 km away, making foods like eggs or milk a rare treat.
The distance exacerbates their struggles. Sandhya’s family survives solely on her daughter’s income, which ranges between ₹100 to ₹150 per day, dependent on her availability for agricultural work. On days when there is no work, the family faces deprivation.
“All she can afford is ragi ambali for breakfast and rice with chaaru for lunch and dinner,” explains Satya, a neighbour and caretaker for those in need of medical aid, in the absence of an Accredited Social Health Activist (ASHA). Locals mention that the ASHA worker from a nearby village tends to only visit during critical times.
Health Impacts of Delayed Treatment
Healthcare professionals note that stomach irritation is a common side effect of anti-TB drugs. They recommend increased fluid intake and a balanced diet to alleviate gastrointestinal issues, along with medical consultations for any exacerbating complications.
“Nutrition plays a vital role in treatment outcomes for patients, and undernutrition—such as that faced by Sandhya—increases the likelihood of disease progression and the risk of death by four to five times,” states Dr. Swathi Krishna, a public health physician and TB researcher in Maharashtra.
Now, seven months after stopping her medications, Sandhya suffers from fever and body aches. The discontinuation of anti-TB drugs raises the risk of relapse or further disease progression to multidrug-resistant TB, although this remains unconfirmed until a hospital visit.
An NGO medical expert who evaluated Sandhya’s condition warns that her life is at risk if she does not promptly resume her medications and improve her nutrition. Dr. Swathi Krishna stresses that a Body Mass Index below 18.5 is a critical factor warranting hospitalization, a category into which Sandhya predominantly falls. “This crucial risk factor is often overlooked at diagnosis,” she adds.
Government Initiatives and Challenges
According to the WHO’s Global TB Report 2025, India leads the world in TB cases, accounting for **28%** of all TB-related deaths globally. As of July 3, 2026, Andhra Pradesh had reported **37,130 TB cases**. The disease, caused by the bacillus Mycobacterium tuberculosis, is often described as a “disease of the poor.” Research indicates that as long as poverty prevails, TB will continue to thrive.
In light of these issues, particularly concerning poverty and undernutrition among marginalized populations, the Union government introduced the Nikshay Poshan Yojana in 2018, providing ₹500 monthly to all notified TB patients throughout their **six-month** treatment. This amount increased to ₹1,000 per month in 2024, funded jointly by the Union and State governments (60:40 ratio). However, many patients in Andhra Pradesh report not receiving this financial aid for six months or longer.
When questioned about payment delays, A.P. State Nodal Officer T. Ramesh cited technological issues with updating payment platforms since December 2025 but assured that the process would be streamlined soon. He also noted that nearly **29,000 patients** received payments in March.
The absence of this crucial support significantly impacts TB patients, particularly in remote and underdeveloped regions like Sandhya’s community.
Sandhya’s situation is not unique. Interviews conducted with five TB patients from Alluri Sitharama Raju, NTR, Chittoor, and Eluru districts revealed that seven others also had not received necessary financial aid. One patient, who began treatment in May 2025, mentioned she received neither financial support nor a nutritional kit.
Similarly, Lakshmi, a **37-year-old** farmer residing in another tribal hamlet in the ASR district, was diagnosed with extrapulmonary TB in June. Discussing her nutrition, she describes having milk, eggs, or vegetables as a luxury, despite her struggles predating the diagnosis with multiple hospital visits over three years leading to her TB confirmation. Initially hesitant to share her story, she eventually disclosed that she had cold abscesses on her neck and chest, which remained undiagnosed for a long time.
Research Insights on Nutritional Support
As per research conducted by expert Anurag Bhargava and others, titled “Nutritional Supplementation to Prevent Tuberculosis Incidence in Household Contacts of Patients with Pulmonary Tuberculosis in India (RATIONS),” providing micronutrients for six months can significantly reduce TB incidence among high-risk groups in close contact with infectious individuals.
This research prompted the Indian government to emphasize nutrition in TB treatment. Consequently, the Ni-kshay Mitra initiative was launched in 2022 to encourage donations of nutritional baskets to TB patients, fostering public engagement in the national effort to eliminate TB.
While many donors registered as ‘Mitras’ in the initiative’s first year, its effectiveness waned over time due to donor fatigue. Dr. Ramesh, the State TB Officer, noted that over **400,000** food baskets were distributed between 2022 and July 2026 in Andhra Pradesh.
Yet, considering each patient requires six baskets—one monthly—this amount only supports more than **66,000 patients**, significantly less than the cases reported within a single year, particularly in 2025.
Challenges in securing donations persist even in urban areas like Vijayawada. Frontline health worker Divya pointed out that even when food baskets are donated, it occurs only periodically, with only **10 out of 100** benefiting from them. In her region, five individuals are currently under TB treatment, and none have received either monetary support or nutritional baskets. “As the closest representatives of the government, we are sought for updates, but we often have no answers,” she laments.
Concluding Remarks on Urgent Needs
As patients and families recount their prolonged uncertainty and difficulties, health officials attribute the delays primarily to digital hurdles. Discussions with ASHAs, Community Health Officers, and TB supervisors statewide highlighted that complications in creating an Ayushman Bharat Health Account (ABHA) ID for TB patients have been significant contributors to these delays.
For TB patients in Andhra Pradesh, timely financial support is as crucial to recovery as the necessary medications and nutrition. The World Health Organization aims for a **90%** reduction in TB incidence and a **95%** decline in related deaths by 2035. Dr. Swathi Krishna emphasizes that achieving this goal is contingent upon improving social conditions—like nutrition and housing, breaking the transmission chain, increasing preventive treatment uptake, and finding an effective vaccine.
(To protect the identities of frontline health workers, TB patients, and locations, names have been withheld or altered.)
