New WHO Guidelines Aim to Integrate Nutrition with Tuberculosis Care
The World Health Organization (WHO) has released fresh recommendations as part of its consolidated guidelines on tuberculosis (TB), highlighting nutrition as a central determinant of TB outcomes. The update aligns with WHO’s End TB Strategy, underscoring that improving nutrition and reducing food insecurity can enhance treatment success, lower mortality, and help break the cycle of poverty and disease.
TB remains a leading global health challenge, claiming millions of lives annually. In 2023 alone, about 1.25 million people died from TB, with undernutrition identified as a key driver that increases susceptibility, worsens disease progression, and undermines the effectiveness of therapy. The new guidelines respond to this reality by advocating for a household-centered approach that treats nutrition as an essential component of TB care.
Core Recommendations: Nutrition at the Heart of TB Care
Nutritional assessment and counselling for all
One of the primary shifts is the universal integration of nutritional assessment and counseling for people with TB and their household contacts. The guidelines recognize that households affected by TB often experience high rates of malnutrition, which can compromise recovery and elevate the risk of transmission within families.
Nutritional interventions for undernourished TB patients
For those identified as undernourished, the guidelines call for targeted nutritional interventions designed to improve clinical outcomes. This applies regardless of patient age, drug resistance status, or pregnancy. Interventions may include dietary support, supplementation, and ongoing monitoring to ensure that nutritional needs are met throughout treatment and recovery.
Food assistance for household contacts in food-insecure settings
In settings where food insecurity is prevalent, the new guidance recommends providing food assistance to the household contacts of TB patients. This approach aims to reduce the risk of TB infection among those living in the same household and to support broader community resilience against the disease.
Why Nutrition Matters in the TB Epidemic
Dr. Tereza Kasaeva, Director of WHO’s Department for HIV, TB, Hepatitis, and STIs, emphasizes that TB thrives in the context of inequity. Undernutrition is a modifiable risk factor that worsens TB outcomes and perpetuates cycles of poverty. Addressing nutrition and food security is therefore not ancillary—it is foundational to ending TB.
By embedding nutrition into person-centered TB care, the guidelines aim to improve early detection, enhance adherence to treatment, and shorten the duration of illness. In turn, this approach is expected to reduce avoidable deaths and contribute to broader social and economic gains for affected communities.
<h2Implementation: Turning Guidelines into Practice
The World Health Organization notes that successful adoption will require coordination across multiple sectors. Governments, nutrition and social welfare agencies, healthcare providers, and community organizations must collaborate to integrate nutritional support with TB services. An operational guidebook will accompany the revised guidelines, offering country-level strategies for stakeholder engagement, program design, and monitoring of outcomes.
Key elements of implementation include routine screening for malnutrition at TB clinics, standardized counselling protocols, mechanisms for cash- or food-based food assistance in eligible settings, and data collection to gauge impact on treatment success and mortality. The guidance also stresses the importance of tailoring interventions to local contexts while maintaining quality and equity in care.
<h2Looking Ahead
As countries adopt the new nutrition-inclusive approach to TB care, the potential for meaningful reductions in TB incidence and better patient outcomes grows. The guidelines are a call to action for integrating nutrition into a holistic, household-centered model that addresses both medical and social determinants of health. With coordinated effort, the global community can move closer to a world where TB is not simply treated but prevented through strengthened nutrition and social support systems.
