Interview: What Lakshadweep can teach the rest of India about eliminating TB

Lakshadweep is India’s smallest Union Territory, an archipelago consisting of 36 islands – 10 of which are inhabited – with an area of 32 sq km. But most islands are two to five hours away on choppy seas, and one particular island, Minicoy, takes a 16-hour ship journey from the headquarters, Kavaratti.

It is in this archipelago that India found its first success on TB elimination. Lakshadweep was declared TB-free in March 2021, three years after a strategy document spelt out the task ahead of the administration.

“The strategy was simple in the way many great public health ideas are simple,” says Rakesh PS, who worked as a World Health Organization consultant supporting India’s National TB Elimination Program in Lakshadweep and parts of Kerala. “But simplicity of an idea should never be confused with ease of execution.”

India recorded about 2.7 million cases of tuberculosis in 2025, as ISignal reported in March 2026. Based on population projections for that year, this translates to an incidence of about 185 cases per 100,000 population.

In an upcoming book, Echoes from the Atoll, Rakesh writes about the challenges and the lessons that Lakshadweep’s TB programme holds.

Rakesh is a public health physician, researcher, and health systems specialist, and has worked with the WHO and The International Union Against...

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