The theme of World TB Day 2026 - "Yes! We Can End TB: Led by countries, powered by people" - resonates strongly with the realities of Nepal. The country has a long history of TB prevention and control, with initiatives from both the non-governmental sector, such as the Nepal Antituberculosis Association established in 1953, and the government sector, including the National Tuberculosis Centre founded in 1989. These institutions laid the foundation for preventive and curative services nationwide. Today, the National Tuberculosis Programme has set ambitious targets: to end TB by 2035 and eliminate it by 2050, defined as fewer than one case per million population. Its strategies focus on achieving over 90 percent treatment success, strengthening Directly Observed Treatment, Short-course (DOTS), expanding GeneXpert diagnostic coverage, and promoting community-based care. Yet despite these efforts, TB remains one of Nepal's most serious infectious diseases, disproportionately affecting the poor, the undernourished, and those living in overcrowded conditions, highlighting not only gaps in the health system but also deep-rooted socio-economic inequalities.

An estimated 70,000 people develop TB in Nepal each year, yet many remain undiagnosed or unreported. As an airborne infectious disease, TB spreads rapidly, and these "missing cases" continue to fuel community transmission. Particularly in urban centres such as Kathmandu and several Terai districts, reported TB cases have remained consistently high. The rising prevalence of drug-resistant TB further complicates treatment, making it longer, more expensive, and less effective. These trends underscore the persistent gap between national commitments and practical implementation on the ground.

The 2026 theme calls for a decisive shift toward country-led action. For Nepal, this means moving beyond policy documents, strategies, and program statements to genuine national ownership of the TB response. While strategies are aligned with global targets, the real challenge lies in translating them into measurable outcomes. Effective leadership requires sustained political will, increased domestic investment, efficient resource allocation, and accountability at all levels of the health system to turn policy into reality. Without these, progress risks remaining slow and fragmented.

To accelerate progress, Nepal must prioritize interconnected actions. Early detection is critical to breaking the chain of transmission, yet many individuals delay seeking care or are not diagnosed in time. Ensuring treatment completion is equally essential, as incomplete treatment fuels drug resistance. Strengthening surveillance systems will enable accurate data for planning and response. At the same time, addressing underlying determinants such as poverty, malnutrition, and overcrowded housing must be integrated into TB control strategies. Additionally, scaling up community-based screening and treatment, expanding diagnostic facilities, and integrating TB control with social support programs can effectively tackle the root causes of disease. Strengthening public-private partnerships and local ownership will ensure that early detection, prevention, and cure reach communities across Nepal, particularly in remote and high-burden areas.

Equally vital is the second pillar of the theme - "powered by people." Nepal's grassroots health system, including female community health volunteers, community health workers, TB survivors, and local organizations, plays a critical role in awareness-raising, case detection, and supporting treatment adherence. Yet, these frontline actors are often under-recognized and under-supported. Empowering them through proper training, fair incentives, and meaningful engagement, involvement and participation in decision-making can significantly strengthen the effectiveness of TB programs.

Ensuring equitable access to TB services remains a persistent challenge in Nepal. Geographic barriers, limited rural health infrastructure, and social stigma often delay diagnosis and treatment. Strengthening last-mile delivery requires bringing services closer to communities through mobile screening, decentralized diagnostic facilities, and community-based treatment support. Building trust is also vital, so that individuals feel safe seeking care without fear of discrimination or social exclusion.

Ending TB will also require innovation and sustained investment. Rapid molecular diagnostic tools can reduce delays in detection, while digital technologies can support treatment adherence and patient monitoring. Increased domestic financing is critical to reduce dependence on external support. Investing in TB control is not only a public health priority but also an economic necessity, as it reduces long-term healthcare costs and prevents loss of productivity.

The message of World TB Day 2026 is clear: ending TB is possible, but only through collective action. Government leadership must be complemented by active community engagement, with civil society, private-sector actors, and international partners working in close coordination. While several organizations, including the Stop TB Partnership and the Global Fund, collaborate with the government to combat TB, efforts to strengthen health systems, expand diagnostic services, enhance private-sector involvement, and promote community participation still require greater focus and prioritization. In particular, public-private partnerships and local community engagement must be intensified to ensure timely detection, effective prevention, and successful treatment at the grassroots level. No single entity can eliminate TB alone; sustained collaboration across all sectors-from policymakers to frontline health workers and the communities they serve-is essential.

Nepal stands at a crucial turning point in its fight against tuberculosis. The tools, knowledge, and strategies needed to end TB are already within reach. What is required now is decisive leadership, community empowerment, and tangible action. By embracing country-led approaches and harnessing the power of its people, Nepal can transform the promise of "Yes! We Can End TB" into reality. The goal is ambitious, but achievable - and the time to act is now.