Mangaluru

A pioneering study by Mangaluru-based doctors Dr. Anurag Bhargav and Dr Madhavi Bhargav, published in the prestigious medical journal The Lancet, has led the World Health Organization (WHO) to revise its global tuberculosis (TB) treatment guidelines.

The couple’s work, part of the RATIONS (Reducing Activation of Tuberculosis by Improvement of Nutritional Status) trial, provided the first large-scale evidence that nutritional support sharply lowers TB mortality and infection rates among patients and their families. The new WHO 2025 guidelines now formally recommend food assistance as a standard component of TB care, a major policy shift worldwide.

Conducted over three years across 2,800 households in Jharkhand, the study found that food baskets containing cereals and pulses reduced new TB cases by 48 percent and deaths by 35 percent. In their Lancet paper, the authors wrote: “Undernutrition is the strongest driver of tuberculosis in India and other developing nations. Addressing nutritional deficiencies is therefore a vital preventive and therapeutic strategy.” They added that “food supplementation should be integrated into national TB control programmes as an essential, not optional, intervention.”Published in both The Lancet and The Lancet Global Health, the study has also influenced India’s Nikshay Poshan and Nikshay Mitra initiatives under the National TB Elimination Programme. Experts say the Mangaluru doctors’ findings have now bridged a critical gap between clinical treatment and public health nutrition.