TB remains one of the world’s deadliest infectious diseases with men disproportionately affected. They face higher TB prevalence, delays in accessing care and poorer treatment outcomes. Adolescents and young adults also face distinct risks that are overlooked in TB programmes. These inequities are shaped by gender norms, poverty, stigma, livelihood pressures and health systems that are not designed around lived realities. Many TB programmes lack disaggregated data needed to identify who is being missed and how services should adapt.
This case study highlights how LIGHT addressed these challenges through gender-responsive and equity-focused research across Kenya, Malawi, Nigeria and Uganda. LIGHT combined primary and secondary data analysis, participatory research and mathematical modelling to examine how sex, gender, age, poverty, education, social position and health-system barriers shape TB risk, access to care and outcomes.
LIGHT found that TB disparities are not merely biological. They are driven by complex social, economical and structural factors. Evidence showed that TB infection risk begins to diverge in late adolescence and persists into adulthood; that men and women experience different gaps across the TB care cascade; and that improving TB treatment coverage among men while addressing structural risk factors could reduce TB incidence by 13–35% by 2035. These findings helped demonstrate that reaching men more effectively can benefit whole communities by reducing transmission to women, children and adults.
LIGHT's evidence was used to inform national policies, guidelines and practice as well as strengthening data systems. LIGHT supported the redesign of TB data collection tools and the integration of sex-disaggregated indicators in Nigeria, helped strengthen modelling and analytics capacity in Kenya, and informed WHO’s decision to report TB treatment outcomes separately for men and women in Global TB Reports from 2024 onwards. The case study shows how gender-responsive, data-driven research can support more inclusive, effective and equitable TB responses.