New research shows how gender-responsive approaches can accelerate progress to end TB

Social stigma, work and financial pressures, and services not designed around people’s daily lives are continuing to delay tuberculosis (TB) diagnosis and treatment, particularly for men and adolescents, new research has found.

The LIGHT Research Programme, funded with UK aid, led by Liverpool School of Tropical Medicine in partnership with organisations in Kenya, Malawi, Nigeria, Uganda and the UK has generated new evidence and practical solutions that are driving measurable improvements in gender-responsive, person-centred care.

TB remains the world’s deadliest infectious disease, with 1.23 million people dying in 2024, despite it being preventable and curable. Each year, more than two million people with TB are missed by health systems, allowing continued transmission within households and communities.

LIGHT’s findings show that TB is shaped not only by biology but also by social and structural factors, including gender norms, poverty, stigma and access to services. Men continue to experience a higher burden of TB and are more likely to delay care due to work pressures, social expectations and health services that do not fit their realities. Adolescents and young adults also face distinct and often overlooked barriers across the care pathway.

LIGHT’s work has begun to close these persistent gender and age‑related gaps, offering scalable approaches that countries are now integrating into national strategies.

Dr Rachael Thomson, CEO of LIGHT said: “Through the LIGHT research programme, supported by UK Aid, we have been able to better understand how gender norms, stigma, and social factors influence access to TB services. The programme has been built on strong partnerships with governments, researchers, civil society, and communities to generate impactful evidence that supports more inclusive, person-centred TB care.”

LIGHT Research Programme

Across four countries, LIGHT placed communities at the centre of research and intervention design. Participatory approaches, including photovoice storytelling and community workshops, enabled people affected by TB to document their lived experiences and help shape local solutions. These insights highlighted how economic pressures, masculine norms and mistrust of formal health systems often lead men to delay care or seek temporary relief from informal providers.

Working alongside communities, the programme co‑developed interventions such as community‑led screening, male‑friendly services and youth‑centred approaches that increased early diagnosis, strengthened retention in care and improved TB outcomes.

In Nigeria, Local TB Action Groups delivered awareness campaigns and mobile digital chest X‑ray screening in male‑dominated spaces, contributing to a 35% increase in reported TB cases, closing a major gender‑driven diagnostic gap.

In Uganda, male‑friendly approaches increased notifications by 51%, demonstrating the impact of redesigning services around men’s daily lives.

In Kenya, flexible and youth‑focused services improved treatment retention among adolescents and young adults, addressing one of the most neglected demographic groups in TB care.

LIGHT also worked closely with governments and policymakers to ensure that evidence translated into action. The programme contributed to national TB strategies, guidelines and policy discussions across partner countries, helping to embed gender-responsive and person-centred approaches within health systems. It also strengthened TB data systems, including improved use of sex-disaggregated data to better understand and address disparities in access and outcomes.

Dr Kerry Millington, Research Uptake Manager of LIGHT said: “Above all, the programme was grounded in the experiences of TB survivors, caregivers, healthcare workers and community members, whose insights ensured that the research remained rooted in lived realities. Engagement with parliamentarians and media partners strengthened awareness, built capacity, and supported more informed prioritisation of TB, helping to deepen understanding of gender-responsive approaches and reinforce accountability in translating evidence into action.

“Ending TB will not be possible unless we close the persistent gap in diagnosis and treatment among men. LIGHT has shown, through evidence, partnerships, and real‑world impact, that this is both achievable and essential.”

LIGHT’s research findings, impact and legacy were presented at a special webinar hosted by LSTM on March 31.