The Last Mile Is Not a Distance: One thing we keep coming back to: our biggest problem isn't discovery. It's delivery.
Ten years ago, fighting TB in India meant tests that took weeks to give an answer, and treatments that took years to work. A lot has changed since then. Drug-resistant TB used to mean almost two years of painful daily injections. Now it can be treated with six months of tablets. Nearly every district has a machine that can confirm TB in under two hours. Some tests don't even need refrigeration and can pick up TB from a simple swab of the tongue, which finally means we can diagnose small children who can't cough up a sample. A computer can now read a chest X-ray in seconds. Most of this equipment is made right here in India.
The 2025 elimination deadline has come and gone. It's worth saying that plainly instead of dancing around it, because the useful response to a missed deadline isn't to reset the clock it's to be specific about what got in the way. This issue is our attempt at that kind of specificity, and a reminder that the last mile isn't a distance to be covered. It's a system to be built.
