Sustainable Strategies in Tuberculosis Management: Bridging Ethnobotanical Pharmacology, Advanced Drug Delivery, and AI-Driven Innovation.

Tuberculosis (TB) persists as a leading infectious disease, with progress in global control complicated by emerging drug resistance, limited access to new therapies, and persistent health disparities. This review presents a comprehensive synthesis of traditional and innovative strategies to combat TB, spanning ethnobotanical and folk medicine practices from Africa, Asia, India, Latin America, and Indigenous communities, integrated within World Health Organization frameworks for traditional medicine. The work is systematically bridging time-honored folk therapies with state-of-the-art advances in drug discovery and machine learning algorithms, nanotechnology-based delivery, and artificial intelligence, evaluating both synergy and unique roles in TB management. Additionally, TB stewardship is critically analyzed through nanocarrier platforms (liposomes, mesoporous silica, graphene oxide), artificial intelligence-driven virtual screening, and host-directed therapies, emphasizing their potential for personalization, improved bioavailability, and overcoming drug resistance. This review underscores the urgent need for the sustainable and ethical production of natural anti-TB agents, considering climate change-induced resource loss. Thus, it is providing a roadmap for integrating traditional knowledge with biomedical research, supporting equitable, culturally sensitive, and ecologically responsible TB care.