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Although the World Health Organization has issued disease-specific guidance for managing key comorbidities, TB care remains largely siloed and poorly equipped to address the growing burden of multimorbidity, particularly in African health systems. In this perspective article, we propose a phased framework for multimorbidity-centered TB care. The first phase emphasizes systematic screening for common comorbidities and establishment of basic referral pathways. The second phase focuses on strengthening coordination between TB programs and existing health and social services, including task sharing and longitudinal follow-up. The third phase advances toward fully integrated, co-located, multidisciplinary models of care that embed TB services within broader multimorbidity platforms. Together, this framework offers a pragmatic roadmap for TB programs to deliver more person-centered, equitable, and efficient care, strengthen primary care systems, and accelerate progress toward ending TB as a public health threat in Africa.<\/jats:p>","DOI":"10.3390\/tropicalmed11020037","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T09:12:01Z","timestamp":1769677921000},"page":"37","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reframing TB Care: A Perspective on Multimorbidity-Centered Care for People with TB"],"prefix":"10.3390","volume":"11","author":[{"given":"Alexa","family":"Tabackman","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sadie","family":"Cowan","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA 02114, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Calderwood","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK"},{"name":"Clinical Research Department, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK"},{"name":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare P.O. 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