Clearing the air: microcosting the carbon impact of drug-susceptible pulmonary TB treatment

<sec><title>BACKGROUND</title>More than 10 million individuals develop active TB each year. The diagnosis and treatment of TB create greenhouse gas emissions, contributing to climate change. This study estimates the carbon footprint (CF) of successfully treating one person with drug-susceptible pulmonary TB (DS-PTB) in India.</sec><sec><title>METHODS</title>We defined the cascade of care for DS-PTB using national guidelines, interviews, and direct observation. We estimated the inputs for TB diagnosis and treatment in United States dollars, kilowatts per hour, and kilometres travelled; we converted them into carbon dioxide emissions equivalents (CO₂e) using an appropriate calculator.</sec><sec><title>RESULTS</title>The CF of diagnosing and treating one person with DS-PTB in India is 103.8 kg CO₂e: 31.9% attributable to diagnosis and 68.1% to treatment. Emissions came primarily from first-line drugs (21.2%), hospitalisations (17.4%), and laboratory processes.</sec><sec><title>CONCLUSION</title>We conservatively estimate that treating all persons with TB in India would produce at least 290,640 metric tonnes of CO₂e per year, approximately the same emissions as 63,182 passenger cars in the United States. It is evident that one of India's leading public health challenges also contributes meaningfully to climate change.</sec>.