By Brandon Lim
September 11, 2026 · 3 min readHealth workers with handheld X-rays screened over 160,000 people in Delhi's slums and put more than 800 tuberculosis patients on treatment, The Union reported March 24, 2026, without waiting for anyone to feel sick.
The Delhi drive shows how a portable X-ray and an algorithm now let India hunt tuberculosis, or TB, door to door in the country that carries a quarter of the world's cases.
The Union, a global lung-health organization, runs the program with India's Central TB Division and the Delhi state government across urban slums in six districts, using 21 handheld X-ray devices linked directly to the national health database.
In August 2026, a research team including Nilesh Saini and Jyoti Jaju published a peer-reviewed evaluation of the community-wide screening in the Indian Journal of Tuberculosis, presenting it as evidence from a large-scale implementation initiative.
Delhi needs the help, since the city reports a tuberculosis prevalence of 747 per 100,000 people, and an estimated 61% of residents have carried the TB bacteria at least once in their lives, most without symptoms.
A chest X-ray can reveal lung damage before a person feels sick, but someone still has to read every image.
That reading job now falls to software, which scores each scan for signs of TB and flags suspicious ones for a confirmatory sputum test.
The World Health Organization (WHO) has recommended such computer-aided detection for TB screening since 2021, and a June 10, 2025 policy statement counted six products that meet its performance standards for people aged 15 and older.
The agency calls X-ray screening with this software one of the critical tools available for closing the global gap in TB case detection, though it does not yet recommend the software for children under 15.
Evidence from India's hardest-to-reach communities backs the approach.
In Chhattisgarh, where tribal groups make up 55% to 77% of the population in the studied districts, three public health facilities ran the qXR software over 2,745 chest X-rays, according to a January 2026 study in Open Forum Infectious Diseases.
The software caught culture-confirmed TB with 93% sensitivity, and TB notifications rose 80.21% during the AI period compared with the baseline months.
The screening also flagged 51 people who reported no symptoms at all, and 20 of them turned out to have TB.
India's stakes dwarf any single city's or state's.
A 2025 global report from the WHO estimated that 10.7 million people fell ill with TB worldwide in 2024, with India alone accounting for 25% of them, the largest share of any country.
Worldwide TB incidence fell year-on-year for the first time since the COVID-19 pandemic, yet the 12.3% decline since 2015 sits far from the 50% reduction the agency had set as its 2025 milestone.
Could scanning whole neighborhoods actually bend that curve?
A team of modelers argued yes in a June 2025 study in the open-access journal PLOS Global Public Health, projecting that X-ray screening of every Indian adult once every five years could avert 49% of TB deaths and 40% of new cases between 2025 and 2035.
The price tag would run $325 million to launch and about $1.1 billion a year to operate.
The modelers pointed out that 52% of Indians with bacteriologically positive TB reported no symptoms, cases a symptom checklist can never find.
History also gives the idea precedent, from a Czech district that cut TB notifications 75% over 12 years of X-ray screening to Vietnam, which nearly halved prevalence in four years of mass sputum testing.
Mass X-ray screening faded decades ago partly on practical grounds, and the modelers wrote that newer technologies increasingly answer those old doubts about cost and logistics.
Limits remain, because a flagged X-ray still requires a laboratory test to confirm TB, and treatment still takes months.
The machines cure nothing on their own, but they change who gets found, and how early.
For more than 800 people in Delhi's slums, that head start has already arrived.
