Tuberculosis (TB) remains one of the world’s deadliest infectious diseases. Despite being preventable and curable, TB is the leading cause of death from a single infectious agent worldwide and consistently ranks among the top ten causes of death globally. TB also disproportionately affects people living with HIV and is a major contributor to deaths associated with antimicrobial resistance. Each year, millions of people fall ill with TB, yet many are never diagnosed or receive care in time.
TB is caused by the bacterium Mycobacterium tuberculosis (M. tuberculosis) and is transmitted through the air when a person with active TB disease coughs, speaks, or breathes. Early diagnosis and timely treatment are essential to save lives and prevent ongoing transmission.
Tuberculosis in Nepal
World Health Organization (WHO) reports consistently rank Nepal among countries with the highest TB burden. Geographic barriers, limited access to specialized care, and delays in diagnosis all contribute to the spread of the disease.
In addition, Nepal faces a significant number of cases of multidrug-resistant TB (MDR-TB). MDR-TB develops when TB bacteria mutate or change in ways that make them resistant to the most effective standard treatments. As a result, receiving care becomes a longer and more complex process.
For people diagnosed with MDR-TB, care often requires extended stays at specialized treatment centers far from home. This can create serious economic and social challenges for patients, their families, and communities, adding to the difficulty of what can already be an overwhelming diagnosis.
Partnering to improve patient-centered TB care
The Birat Nepal Medical Trust (BNMT) is a Nepalese non-governmental organization dedicated to improving the health and well-being of people across Nepal. For decades, BNMT Nepal has worked closely with communities and national partners to strengthen TB prevention, diagnosis, and care.
One major challenge in MDR-TB care in Nepal is the limited availability of inpatient treatment facilities. To address this gap, BNMT Nepal worked with partners on improving holistic, patient-centered care at MDR-TB treatment hostels. These hostels provide essential support for people undergoing treatment, which often lasts several months and requires individuals to travel days away from their home districts. During this time, patients are separated from family, work, and community, making supportive care environments especially critical.
Air sampling as an additional tool in TB detection and prevention
While strengthening clinical care is essential, ending the TB epidemic will also require new tools to detect and interrupt transmission earlier. Although TB is airborne, most diagnostic approaches rely on identifying disease after people develop symptoms and seek care. Globally, a substantial proportion of people with TB are never diagnosed, allowing transmission to continue unnoticed.
To help address this challenge, BNMT and Lungfish have partnered to explore air sampling as an additional tool for TB detection and prevention. Air sampling aims to detect M. tuberculosis directly from the environment by capturing airborne bacteria. If successful, this approach could help identify locations where TB transmission may be occurring and enable medical and public health professionals to prioritize those areas for targeted outreach, testing, and infection prevention measures. Air sampling is intended to complement existing diagnostic tools.
Latest activities in Nepal
In early 2026, BNMT and Lungfish began conducting air sampling activities in MDR-TB treatment hostels, where the TB presence is already known, to evaluate whether samplers such as InBio’s Apollo Air Sampler and the InnovaPrep Cub sampler can collect M. tuberculosis in real-world conditions. Detection of the bacteria is facilitated by Cepheid GeneXpert instruments that BNMT obtained through their IMPACT TB program. These hostels provide an important pilot environment to assess the feasibility and performance of air sampling over time.
Sampling activities are being carried out over several months to determine whether airborne M. tuberculosis can be consistently captured and detected. Findings will be shared with partners and community stakeholders in Nepal to inform future research, implementation strategies, and potential integration into TB control efforts.
Looking ahead: future plans
On this World TB Day, we recognize that ending TB will require sustained collaboration, innovation, and a commitment to equity in global health. By combining patient-centered care with new tools to better understand where transmission occurs, BNMT and Lungfish aim to contribute to a future where TB is detected earlier, treated more effectively, and ultimately eliminated as a public health threat. Together, we remain committed to advancing solutions that put people, communities, and science at the center of TB care.