Pakistan elephants with tuberculosis gulp 400 human TB pills daily, hidden in rice balls by Karachi Safari Park staff. Malika and Madhubala, 4,000-kg residents, learn to tolerate the bitter medicine after several weeks of “cranky” charges and pill-laced treats.

Cranky elephants once spat out the medicine before adapting to this jumbo medical challenge. Veterinary surgeon Buddhika Bandara, overseeing the treatment, notes the same drugs treat TB in humans—now repurposed for wildlife health. Each rice ball holds a pharmaceutical surprise.

Each elephant’s daily pill count equals nearly two months’ worth of human TB treatment—crammed into one day’s breakfast routine.