Overview of the Project: Building and Operationalizing a Community Care Model for People with Drug-Resistant Tuberculosis in India

The Mueller Health Foundation’s collaboration with the Resource Group for Education and Advocacy for Community Health (REACH) based in India will focus on a 2-year pilot project aimed at building and operationalizing a community care model for people with drug-resistant tuberculosis in Tamilnadu, India.
India currently has the highest number of people with tuberculosis (TB) and drug-resistant tuberculosis (DRTB) in the world, comprising almost a quarter of the total burden. According to the India TB Report 2022 1 , 48,232 people were diagnosed with multi-drug resistant/rifampicin resistant tuberculosis (MDR/RRTB) in 2021, which is 4.11% of those tested for rifampicin resistance. Treatment success rates remain suboptimal, at 48% and 60% respectively for people with DRTB initiated on shorter regimens and conventional regimens. Treatment for drug- resistant TB has traditionally been hospital or facility-based management and ambulatory care. However, facility-based interventions have their limitations including lengthy and costly travel.
In this context, community-based care emerges as a viable alternative. REACH’s experience in working with TB survivors over the last six years has shown the need for and the impact of involving affected communities in designing public health interventions. The active participation of those most affected by the disease – people with TB, TB survivors and their families – provides an opportunity to tailor services to particular needs, rather than adopt a one-size-fits-all approach. The collaboration between REACH and MHF therefore aims to design and operationalize a community care model for drug-resistant TB to provide comprehensive, holistic, services for those affected by DRTB in two selected districts of Tamilnadu in India. The goal of this project is to reduce morbidity and mortality due to drug-resistant TB through decentralized care at the community level. The project will include a rapid assessment and landscape mapping of DRTB care models in India, the design and implementation of a community care model for people with drug-resistant TB and the improved information sharing through the use of MHF's TBConnect Blockchain Portal.


REACH is an India-based non-profit organization founded in 1998 in Chennai. For over two decades, through an unrelenting focus on TB, REACH has demonstrated capacity to engage diverse stakeholders including the private sector, TB-affected communities, industry leaders, elected representatives and the media. REACH currently works across the country, in over 20 states, through projects supported by various donors.
REACH was one of the first organization globally to develop and operationalise an interface model between the public health system, private providers and people who seek care for TB in the private sector. Building on this successful model, REACH today provides integrated screening for TB and NCDs – Diabetes and Hypertension – for people seeking care in the private sector in Chennai. REACH first demonstrated the capacity-building and engagement of TB survivors as Champions through the Call to Action project (2016-20) supported by USAID. The project resulted in India’s first cadre of over 300 TB survivors trained as TB Champions and the formation of seven survivor-led networks. Today, this model has been formally adopted by the NTEP and TB Champions are recognized as a key actor in the TB response and critical to achieving TB elimination goals. For more information about REACH, visit www.reachindia.org.in.