India has the highest number of TB cases globally, according to the World Health Organization's 2017 report, and is also among the top five countries that report the highest multi drug resistant cases. Over the past year, there were more than 1 million TB cases reported across India, according to health ministry data. Campaigners argue that the numbers are even higher, as there are gaps in the detection and treatment of TB.
Adding to the health crisis is the increasing debt burden on patients as they try and stick with the treatment, say public health campaigners. Expenses such as transportation and the cost of food, combined with the loss of income, push families into debt and are disincentives to continuing treatment, they say.
A study presented at the European Respiratory Society's 2016 conference in London documented the "catastrophic costs" incurred by TB patients undergoing treatment at private hospitals. The study showed that patients were spending 235 percent of their income on the disease - meaning they had to borrow money to support their treatment.
"Not only is TB a disease of poverty, it also causes poverty," said Zarir F. Udwadia, a leading chest physician.
"It affects mainly poor and malnourished people," Finance Minister Arun Jaitley told parliament - a rare official acknowledgement of the scale and impact of the disease.
Patients often stop taking their medicines due to the side effects and the financial strain, said Radha Garikapati, a counsellor at the Hospital of Infectious Disease.
"Adherence has always been our biggest challenge," she told the Thomson Reuters Foundation between counselling sessions. "Almost all patients tell us about their debts and finances," she said. "We provide them with some nutritional support, but wages lost due to the illness is something we can't compensate."