WHO Issues New Guidelines on Undernutrition and Tuberculosis

The updated recommendations call for universal nutritional assessment and counselling for people with TB and their household contacts, acknowledging that many individuals in TB-exposed households may also suffer from undernutrition. They also advocate for targeted nutritional interventions to optimize clinical outcomes in TB patients with undernutrition, regardless of age, pregnancy status, drug resistance, or severity of malnutrition. A particularly novel recommendation is to provide food assistance to household contacts of TB patients in food-insecure settings, drawing evidence from the Reducing Activation of Tuberculosis by Improvement of Nutritional Status (RATIONS) trial.

“Tuberculosis thrives on inequality, with undernutrition as a major driver,” said Dr Tereza Kasaeva, Director of the WHO Department for HIV, Tuberculosis, Hepatitis, and Sexually Transmitted Infections. “To end TB, we must address undernutrition and food insecurity as part of a comprehensive, household-centred response. Integrating nutrition into comprehensive TB care is essential to breaking the cycle of disease and poverty, and constitutes a critical step towards a world free of TB.”

Implementation of the new guidance will demand cross-sector collaboration. To aid this, the WHO plans to release an operational handbook to guide countries on stakeholder engagement, coordination, and practical steps to embed food and nutrition interventions into national TB programs.

Reference: https://www.who.int/news/item/08-10-2025-who-releases-new-guidelines-on-tuberculosis-and-undernutrition