Enhancing health literacy and meaningful involvement of tuberculosis patients with multimorbidity in high burden settings: a call to action for India

Improvements in living conditions, changing lifestyles, and healthcare advancements have led to an increased prevalence of non-communicable diseases (NCDs) globally, especially in low- and middle-income countries (LMICs). This dual burden of chronic communicable diseases, such as tuberculosis (TB), and NCDs results in multimorbidity—the coexistence of two or more chronic conditions. In India, which contributes 28% of the global TB burden, TB multimorbidity is particularly challenging, with conditions like diabetes, HIV, and depression frequently co-occurring with TB. Effective management of TB multimorbidity necessitates enhancing health literacy, which is foundational for chronic disease self-management. Limited health literacy significantly hinders patients’ ability to understand and manage their conditions, exacerbating health inequalities. This perspective paper examines the critical role of health literacy in TB multimorbidity management, emphasizing community-based interventions such as TB champions, who play a pivotal role in peer education, addressing misconceptions, and fostering patient empowerment. By making medical information more accessible and culturally relevant, these interventions can enhance treatment adherence and health outcomes. Furthermore, policy efforts must prioritize health literacy and multimorbidity management, fostering interdisciplinary collaboration among healthcare professionals, community stakeholders, policymakers, researchers, and patients. Such a multi-stakeholder approach is essential to develop integrated, patient-centered care models that improve the long-term well-being and outcomes of TB patients with multimorbidity.