In Pursuit of Development The poverty trap that kills a million people a year | Madhukar Pai
Apr 15, 2026
Madhukar Pai, Canada Research Chair in Epidemiology and TB expert at McGill, discusses why tuberculosis persists in poverty, undernutrition, overcrowding, and weak primary care. He covers transmission and diagnosis challenges, the role of social protection like food and cash transfers, limits of donor-driven aid, and what decolonizing global health and local innovations mean for lasting solutions.
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TB Is A Disease Of Social Neglect
- TB is primarily a disease of neglect that tracks poverty, undernutrition, overcrowding and weak primary care.
- Madhukar Pai points to outbreaks among indigenous communities in Canada and sustained transmission where social conditions remain poor.
Food Works Like A Vaccine Against TB
- Undernutrition is a powerful, direct risk factor for developing and dying from TB.
- The RATIONS trial in India gave monthly food baskets and cut TB incidence among family members by about half.
Provide Social Protection For Every TB Household
- Implement universal social protection for TB-affected households to cut cases and deaths.
- Cash transfers or food rations (e.g., India's monthly TB cash or $10 food baskets) substantially reduce incidence and mortality.