On a busy street in Hyderabad, India, a community health worker (CHW) begins her daily home visit, going door to door, asking questions about lingering coughs, chest pains, loss of appetite, unexplained weight loss and other symptoms. She talks openly about tuberculosis (TB) and assures families that it is curable—skills she learned from a recent training to address stigma in TB reporting.
Nearly one in four people living with TB go undiagnosed and untreated, allowing it to spread silently through communities and remain a leading cause of death in many parts of the world.
Behind these numbers are real people facing stigma, misinformation and systemic barriers that keep them from seeking care. CHWs are uniquely positioned to connect people with quality TB care by educating their communities about the disease, while reducing stigma.
Through J&J CareCommunity, our social impact platform, Johnson & Johnson and the Johnson & Johnson Foundation are investing in programs that empower health workers across India, which bears the world’s highest burden of TB, to support timely diagnosis, mobilize their communities and help more people access quality care.
A CHW-centered intervention to address TB underdiagnosis in India
In strategic collaboration with India’s National TB Elimination Program, we are working with PATH and TB Alert India on the “Take Charge Against TB” public health initiative.
Through its dual activation model, the “Take Charge Against TB” initiative simultaneously mobilizes health workers and young people to address TB underdiagnosis in their communities. Health workers are trained to screen individuals for TB symptoms, address stigma and build community trust—enabling earlier detection and empowering people to seek care promptly. They also lead health promotion activities that encourage communities to take action for their well-being. During a six-month pilot earlier this year, the initiative:
- Upskilled more than 1,500 community health workers across more than 130 communities in Delhi, Hyderabad and Pune.
- Improved health worker knowledge, attitudes and practice by nearly 20 percent, with two thirds beginning to screen and refer people to care.
- Reached more than 16 million people through multi-channel educational outreach encouraging self-screening and enrollments for free testing.
- Facilitated more than 1,000 health education activities—led by youth volunteers and local J&J employee coaches – to support community health workers.
Ms Sonali, an ASHA worker from Pune shared, “With the mentoring, I see these three changes in me: increased confidence, improved communication skills and strengthened relationship with the NTEP team.”
Building on early success, work is underway to explore expanding the initiative across multiple states and train even more CHWs to help eliminate TB—bringing us closer to a future where timely, equitable TB care reaches every community in need.
Ms. Vimlesh, an Accredited Social Health Activist (ASHA) worker from Delhi, shared, “[The training] made me speak confidently to the community during screening beyond technical information, like stigma, myths and effective communication.”
Urmila Soavane, an ASHA from Pune stated “The training was very helpful. I gained updated knowledge about TB and, more importantly, learned how to address stigma—especially when engaging with people from different age groups and those living in urban slums.”
Listening to those who lead TB efforts on the frontlines of care
Johnson & Johnson is also collaborating with the Center for Tuberculosis at the University of California San Francisco on the two-year TB-DaSH project to create a global framework to support health workers to address underdiagnosis.
Through two regional consultation workshops in Hyderabad, India and Nairobi, Kenya, and a global consultation in Copenhagen during the World Conference for Lung Health, TB-DaSH is bringing together community advisors and organizations, implementers and health workers, academia and National TB Programs. These sessions create space for health workers on the frontlines to better understand barriers to TB care, identify what’s working to overcome these challenges and build global consensus on the most impactful actions and tools.
Mercy, a public engagement specialist and health advocate in Uganda, serves as Co-Chair of the Community Advisory Board at the University of California Tuberculosis Research Advancement Center, shared, “I have witnessed how stigma rooted in limited knowledge among health workers and communities hinders progress ... By elevating lived experiences alongside scientific expertise, we help shape tools and strategies that equip health workers to deliver safer, more inclusive care.”
Empowering CHWs is critical to ending TB for good
In high burden geographies, J&J CareCommunity is working hand-in-hand with communities to address underdiagnosis. Our efforts have reached over 120 million people at risk of living with undiagnosed TB and helped connect 15 million people to screening and testing.
By supporting health workers, we’re helping transform how communities respond to TB and building a future where no one is left behind in the journey to end TB.