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Tuberculosis preventive treatment: the next chapter of tuberculosis elimination in India
  1. Patrick K Moonan1,
  2. Sreenivas A Nair2,
  3. Reshu Agarwal3,
  4. Vineet K Chadha4,
  5. Puneet K Dewan5,
  6. Umesh D Gupta6,
  7. Christine S Ho3,
  8. Timothy H Holtz3,
  9. Ajay M Kumar7,
  10. Nishant Kumar8,
  11. Prahlad Kumar9,
  12. Susan A Maloney1,
  13. Sundari R Mase10,
  14. John E Oeltmann1,
  15. C N Paramasivan11,
  16. Malik M Parmar12,
  17. Kiran K Rade12,
  18. Ranjani Ramachandran12,
  19. Raghuram Rao8,
  20. Virendra S Salhorta8,
  21. Rohit Sarin13,
  22. Sanjay Sarin11,
  23. Kuldeep S Sachdeva8,
  24. Sriram Selvaraju14,
  25. Rupak Singla15,
  26. Diya Surie1,
  27. Jamhoih Tonsing16,
  28. Srikanth P Tripathy17,
  29. Sunil D Khaparde8
  1. 1 Global Tuberculosis Branch, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  2. 2 Stop TB Partnership, Geneva, Switzerland
  3. 3 CDC India Country Office, U.S. Centers for Disease Control and Prevention, New Delhi, India
  4. 4 Department of Epidemiology and Research, National Tuberculosis Institute, Bangalore, India
  5. 5 Global Health, Bill and Melinda Gates Foundation, Seattle, USA
  6. 6 National JALMA Institute for Leprosy and other Mycobacterial Diseases, Agra, India
  7. 7 Department of Research, International Union Against Tuberculosis and Lung Disease, Paris, France
  8. 8 Revised National Tuberculosis Control Programme, India Ministry of Health and Family Welfare, New Delhi, India
  9. 9 National Tuberculosis Institute, Bangalore, India
  10. 10 WHO India Country Office, World Health Organization, New Delhi, India
  11. 11 India Country Office, Foundation for Innovative New Diagnostics, New Delhi, India
  12. 12 India Country Office, World Health Organization, New Delhi, India
  13. 13 National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
  14. 14 Department of Epidemiology, National Institute for Research in Tuberculosis, Chennai, India
  15. 15 Department of Tuberculosis and Respiratory Diseases, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
  16. 16 South-east Asia Office, International Union Against Tuberculosis and Lung Disease, New Delhi, India
  17. 17 National Institute for Research in Tuberculosis, Chennai, India
  1. Correspondence to Dr Patrick K Moonan; pmoonan{at}


The End TB Strategy envisions a world free of tuberculosis—zero deaths, disease and suffering due to tuberculosis by 2035. This requires reducing the global tuberculosis incidence from >1250 cases per million people to <100 cases per million people within the next two decades. Expanding testing and treatment of tuberculosis infection is critical to achieving this goal. In high-burden countries, like India, the implementation of tuberculosis preventive treatment (TPT) remains a low priority. In this analysis article, we explore potential challenges and solutions of implementing TPT in India. The next chapter in tuberculosis elimination in India will require cost-effective and sustainable interventions aimed at tuberculosis infection. This will require constant innovation, locally driven solutions to address the diverse and dynamic tuberculosis epidemiology and persistent programme monitoring and evaluation. As new tools, regimens and approaches emerge, midcourse adjustments to policy and practice must be adopted. The development and implementation of new tools and strategies will call for close collaboration between local, national and international partners—both public and private—national health authorities, non-governmental organisations, research community and the diagnostic and pharmaceutical industry. Leading by example, India can contribute to global knowledge through operational research and programmatic implementation for combating tuberculosis infection.

  • Tuberculosis
  • Chemoprophylaxis
  • Prevention strategies
  • Public Health

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • PKM and SAN contributed equally.

  • Handling editor Alberto L Garcia-Basteiro

  • Contributors PKM and SAN conceived, designed and drafted the initial manuscript. PKM, VKC, JEO acquired and analysed the data. RA, CH, THH and DS provided technical support to interpreting the results. RA, VKC, PD, UDG, CH, THH, AK, NK, PK, SAM, SRM, JEO, CNP, MMP, KKR, RR, RR, VSS, RS, SS, KSS, SS, RS, DS, JT, SPT and SDK revised the initial draft and provided critically important intellectual content. PKM and SAN integrated all feedback and investigated and resolved any questions from internal and required clearance at CDC and WHO prior to publication. SDK provided overall leadership and oversight. All authors attest to the accuracy and integrity of final version.

  • Funding This study was funded in part by U.S. President’s Emergency Plan for AIDS Relief.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Unless otherwised stated, all data presented are in the public domain and freely avaialble for use.

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