To augment a recent study highlighting the concerning rise in the global burden of multidrug-resistant tuberculosis (MDR-TB) among children and adolescents, this article presents the realities in India, stressing the urgent need for enhanced TB elimination strategies. It explores how insufficient data, rising air pollution, and recent U.S. sanctions impede the detection and control of pediatric TB burden including MDR-TBs in India. This article serves as a wake-up call for stakeholders to take decisive actions while facilitating future research and policy development. We provide targeted recommendations to address vulnerabilities and prevent a potential public health crisis.
© 2025. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.