Lakshadweep is presented as India’s first state/UT at TB-elimination levels (certified TB-free geography in 2021). Since December 2024 only 35 cases notified; 14 in 2026 so far (some transfers from Kerala)—6 completed treatment, 8 still on it, all drug-sensitive, none MDR, 3 extra-pulmonary. Isolation (hours by ship, monsoon blackouts) became close-knit surveillance: island TB committees, people known by name.

Find: quarterly ASHA door-to-door screens; teachers and Friday-prayer talks; panchayats run camps. Diagnose: Truenat molecular tests on all 10 inhabited islands (some machines reused from COVID); ICMR AI X-rays plus a handheld unit in Kavaratti; cultures still go to Thiruvananthapuram. Treat: monthly MO visits, daily ASHA DOT, STS/STLS phone checks, 10 kg food baskets for patient and carer, timely Nikshay Poshan cash, contacts offered preventive therapy.

Lesson the piece draws for Union World Conference on Lung Health 2026: prevent–find–treat everyone, person-centred, no one left behind. Admin backing and community ownership matter more than geography. Remaining hitch: broken Truenats must sail to the mainland for repair. “The sun of a TB-free India arose in the west.”

In a landmark public health achievement, Lakshadweep became the first among Indian states and union territories to reach TB elimination levels. Lakshadweep is a sterling example that if we prevent-find-treat ALL TB in a person-centred and rights-based manner where “no one is left behind,” we can end TB – even in a part of a country like India (which has the highest TB burden globally).

Ahead of Union World Conference on Lung Health 2026, the End TB Dialogues session featured Dr MP Nezeeda, the State TB Officer of Lakshadweep, who shared insights from the territory’s journey to TB elimination.

She highlighted how sustained community engagement, active and intensified door-to-door screening, regular followup of those on TB treatment to ensure treatment adherence, and strong administrative support turned geographic isolation into a strength.

The remote archipelago of Lakshadweep islands in Arabian Sea on the south-west coast of India, separated from the land by hours of sea travel, has notified remarkably low numbers of TB cases. Since December 2024, only 35 TB cases have been reported. From January of the current year, 14 people with TB disease were notified, including those who were transferred from nearby Kerala. Six of those patients have completed treatment, with eight still undergoing care. All current cases are drug-sensitive, with no multi-drug-resistant TB recorded, and three are extra-pulmonary, said Dr Nezeeda.

Island geography........

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