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This process document summarises the first three years of the implementation of the USAID-initiated Tuberculosis Health Action and Learning Initiative (THALI) in West Bengal. The project covered six districts, that had a population of 14.3 million people and included 22% of the slum population. THALI was initiated to improve TB service delivery in urban and rural areas of West Bengal by working with the Government of West Bengal (GoWB) and the private sector; the project also established service delivery models to deliver high quality care, helped strengthened the capacity of the Public Health System and the private sector through the use of management systems and technology to optimize quality and promote innovative solutions. As part of this initiative, THALI mapped private providers of TB services in the six districts, trained public health providers, engaged local NGOs, worked on raising TB awareness, and supported active case finding and treatment. This document will help implementers initiate similar TB prevention and treatment programs in other parts of the country.