Can Gangtok's Nikshay Sivir Training Be India's Blueprint to Beat TB?

India carries the world’s highest tuberculosis (TB) burden, accounting for 26% of global cases. Despite the government’s ambitious TB Mukt Bharat (TB-Free India) mission, aiming to eliminate the disease by 2025, five years ahead of the UN’s Sustainable Development Goal, progress remains uneven. But a new initiative in Gangtok, Sikkim, might hold the key to turning the tide.

On June 17, 2025, the District Tuberculosis Control (DTC) Gangtok conducted a high-impact training program for Nikshay Sivir, a frontline initiative aimed at accelerating TB elimination. The session focused on latent TB detection, preventive therapy, and a groundbreaking “Smart Sivir Strategy,” a community-driven approach that could reshape India’s fight against TB.

Could Gangtok’s model be India’s blueprint for TB elimination?

Inside Gangtok’s “TB War Room”: The Smart Sivir Strategy

The training brought together healthcare workers, policymakers, and NGOs for an intensive workshop on TB prevention, not just treatment. Unlike traditional programs that focus on diagnosing active TB cases, Gangtok’s strategy targets latent TB infections, where the bacteria lie dormant but can later become active and infectious.

Key elements of the Smart Sivir Strategy include:

Mobile Screening Units – Reaching remote villages where healthcare access is limited.
Community TB Champions – Local volunteers trained to identify symptoms early.
Preventive Therapy – Treating latent infections before they spread.
Digital Integration – Using the Nikshay portal to track cases in real-time.

“For years, we chased active TB cases. Now, we’re stopping TB before it starts,” said a DTC Gangtok official (name withheld for privacy).

Why Latent TB is the Missing Piece in India’s Elimination Puzzle

The WHO’s End TB Strategy emphasizes prevention as much as cure. Yet, most Indian programs still focus on detecting and treating active TB, missing the 4–5 crore Indians estimated to have latent TB. If untreated, 5–10% of these cases progress to active TB, perpetuating the cycle.

Gangtok’s training tackled this gap head-on, teaching ASHA workers and nurses how to:

Identify high-risk groups (diabetics, HIV patients, malnourished children).
Administer TB Preventive Therapy (TPT), a 3-month course that cuts infection risks by up to 90%.
Debunk myths (e.g., “TB only affects the poor”).

“Latent TB is like a ticking bomb. Gangtok’s approach defuses it,” explained a healthcare worker who attended the session.

From Gangtok to India: Can This Model Scale Nationally?

Gangtok isn’t alone in innovating. Mangan and Pakyong districts in Sikkim have also seen success with the TB-Free Panchayat Awards, which incentivize local leaders to boost screening efforts. But for nationwide impact, three hurdles remain:

Funding – Preventive therapy requires sustained investment.
Rural Healthcare Gaps – Many villages lack diagnostic tools.
Stigma – Fear of isolation keeps patients from reporting symptoms.

Yet, Gangtok’s public-private partnerships—like engaging Nikshay Mitras (TB supporters) and local pharmacies—offer a replicable template.

The Road Ahead: A TB-Free India by 2025?

The government’s National Strategic Plan 2017–2025 already aligns with Gangtok’s methods. If other states adopt similar prevention-first strategies, India could see:

Faster decline in new cases (goal: 80% reduction by 2025).
Fewer deaths (target: 90% drop in mortality).
Lower costs – Treating latent TB is cheaper than managing outbreaks.

“Elimination isn’t just possible it’s within reach if we act now,” asserts a senior health official.

Conclusion: A Call to Action

Gangtok’s training demonstrates that TB elimination requires more than just medicine—it necessitates community mobilization, early prevention, and political will. If India scales this model, 2025 could mark a historic victory against one of humanity’s oldest diseases.

What’s next?