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Just 10 years ago, Idukki was one of Kerala’s worst performing districts in tuberculosis (TB) control. In 2006, the district TB Centre decided to fill all vacancies of medical officers and laboratory technicians in order to improve access to diagnosis and treatment, and proactively screen the population to detect cases instead of only testing those who showed up at a doctor’s with TB symptoms. This led to an initial spike in the number of cases detected until 2009, after which the number has steadily fallen. This shows how simple improvements in the public healthcare infrastructure can help India’s anti-TB efforts. This is the second of our four-part series on Kerala’s successful TB programme.