India

An MSF staff member converses with Anam (name changed), a 17-year-old DRTB (Drug Resistant Tuberculosis) patient and her mother outside the MSF DRTB Clinic, Chembur, Mumbai. Anam (name changed on request), a bright 17-year-old, excels not only at English and Science in school but is an equally good Mehndi/henna artist. She tells us happily that she has completed a professional Mehndi course and learnt needlework. She aspires to become a fashion designer. She scrolls through her phone gallery, bringing up photos of the bridal henna designs that she has created. As her hand moves over the screen, there is a contrast between those delicate designs and the pattern on her own hand from the PICC Line (Peripherally Inserted Central Catheter). Anam was first diagnosed with pulmonary TB at the age of nine. Before her diagnosis, she frequently had a cough and a fever. When her mother initially took her to a doctor, she was suspected of having double typhoid. Being diagnosed with TB at such a young age came as a blow to Anam’s family, who had no history of the disease. Her mother later got to know that Anam studied with around eight to ten TB positive patients in school. The stigma around the disease is so strong that other children or their families never informed the school authorities. The parents feared that their children would be expelled, bullied, harassed or discriminated against. Anam’s mother decided that it was important to break this lethal chain. She informed the Principal and did not send Anam to school for the next five months. For 14 months, Anam received treatment at a private hospital with support from her immediate family and friends. However, the treatment did not work and her symptoms such as weight loss and vomiting worsened. The treatment at the private hospital cost her family around Rs 5,500 monthly (Rs 2,500 for medicines and Rs 3,000 for tests). In February 2021 she was finally diagnosed with drug-resistant tuberculosis (DR-TB) at a government DR-TB centre. She was put on a DR-TB regimen, however subsequent investigations revealed additional resistance to other drugs as well. She suffered from cough, fever and weight loss. Since her condition was not improving with the treatment received so far, she ultimately came to MSF. At the MSF Clinic, Anam was put on a regimen of the oral drugs bedaquiline, delamanid, linezolid and amoxicillin, and an intravenous treatment with the injection imipenem. This regimen was built for her based on her resistance to certain drugs and she has been taking it for the last one and a half years. Anam’s mother says, “We have been through a very rough patch, but we found help every step of the way. The psychosocial support in terms of counselling, and the medical support that we received at the MSF clinic reduced our financial and medical treatment worries.” Despite constant encouragement and support, every day Anam is also witness to another TB story unfolding outside her bedroom window. The impact of stigma and lack of awareness about TB is having serious consequences for a girl not much older than Anam in the neighbouring house. Anam recalls distraught conversations with her ‘window friend’: how she has been locked inside her room because of the disease; how her parents have abandoned her; and the irregularity of her meals. Anam’s mother says that their neighbours don’t allow other community members to help them. Bereft of medical and psychosocial support, her ‘window friend’ developed suicidal tendencies that resulted in one failed attempt to jump off the roof. Anam realises that her friend’s parents may have prevented the suicide attempt, yet they contributed nothing to alleviating the everyday suffering. No proper treatment is sought, she says. Anam’s mother tried to counsel the girl’s parents but they are reluctant to listen to anyone. The story of Anam and her ‘window friend’ highlights the importance of medical treatment and psychosocial support in TB treatment, and the importance of raising awareness around the disease and fighting stigma. And for Anam, even a small dream like hanging out with friends on a vacation post-recovery, keeps her going.

In Mumbai, we treat complex cases of drug-resistant tuberculosis and work with health authorities to reduce high tuberculosis incidence and death rates in the area. We also provide comprehensive care to people living with advanced HIV in Bihar, essential healthcare via mobile clinics in remote areas of Chhattisgarh, and mental health services in Jammu and Kashmir.

Our activities in 2023 in India

Data and information from the International Activity Report 2023.

797

STAFF IN 2023 (full-time equivalent)

€16.4 M

16.4M

Expenditure in 2023

1999

Year MSF first worked in the country

MSF in India in 2023 Médecins Sans Frontières (MSF) runs programmes in India aimed at improving care for tuberculosis (TB), HIV and other infectious diseases, and access to essential healthcare for remote communities.

In Mumbai, MSF’s clinic treats complex cases of drug-resistant TB (DR-TB), including extensively drug-resistant forms of the disease, with innovative drug combinations. For children under five, we implement all-oral regimens. The clinic also supports some palliative care patients when all available treatment options have failed.

In addition, we work with the National Tuberculosis Elimination Programme and Municipal Corporation of Greater Mumbai to reduce high TB incidence and death rates in the area. Our team co-manages a DR-TB centre in a public hospital, and we support diagnosis, treatment, counselling, contact tracing and health promotion.

In Manipur, our project caring for people living with HIV, TB, DR-TB and hepatitis C was severely disrupted when conflict broke out in May, effectively dividing the state into two ethnically separate areas. At the end of the year, as this continued to pose significant challenges to the provision of care and the medical supply chain, our teams were monitoring needs and exploring possible short-term emergency interventions.

In Mizoram state, northeast India, we offered basic healthcare and specialist referrals for refugees from Chin state, Myanmar, at our clinic in Zawkhatar. In displacement camps in the southern-border districts of Champhai, Siaha and Lawngtlai, we provided newly arrived families with relief items such as tents, and cooking and hygiene kits, as well as access to water and sanitation facilities, and medical referrals.

We closed our sexual violence treatment centre in the capital, New Delhi, in November, but will continue to work with other organisations to call for improved access to care for victims and survivors in India. This involves addressing the existing legal and medical barriers that prevent people from seeking urgent treatment.

MSF’s other projects in India include the provision of comprehensive care to people living with advanced HIV in Bihar, essential healthcare via mobile clinics in remote areas of Chhattisgarh, and mental health services in Jammu and Kashmir.

In 2023

20,800

20,8

individual mental health consultations

6,440

6,44

people treated for malaria

830

83

people started on treatment for TB, including X for MDR-TB

640

64

People treated for sexual violence

Kala azar-HIV co-infection in Bihar, Animated explainer | ENG

Have you heard of kala azar?

Kala azar is a neglected but potentially fatal tropical disease. India accounts for 30 per cent of cases worldwide.

This short animation explains what kala azar is, how it relates to HIV, and what we are doing in response.

Since 80 per cent of India's kala azar cases are reported in Bihar, we set up a programme there in 2007.

People living with HIV are particularly vulnerable to kala azar, so since 2016 we have been focusing on treating patients co-infected with the two diseases, in partnership with the Rajendra Memorial Research Institute of Medical Sciences (RMRIMS) in Patna, Bihar.

India

Better detection, diagnosis and treatment needed for neglected complication of kala azar in Bihar

Press Release 10 Apr 2014

India

Access to kala azar treatment in public healthcare system needs to be scaled up

Project Update 28 Mar 2014

Journal article

Directly-Observed and Self-Administered Tuberculosis Treatment in a Chronic, Low-Intensity Conflict Setting in India

20 Mar 2014

Journal article

India

A step closer to effective treatment of severe acute malnutrition in Bihar

Press Release 3 Mar 2014

Journal article

Infection control in households of drug-resistant tuberculosis patients co-infected with HIV in Mumbai, India

1 Mar 2014

Journal article

Five-Year Field Results and Long-Term Effectiveness of 20 mg/kg Liposomal Amphotericin B (Ambisome) for Visceral Leishmaniasis in Bihar, India

2 Jan 2014

Journal article

Contact us

Treating kala azar-HIV co-infection in Bihar, India

MSF India

5th Floor, Okhla NSIC Metro Station Building
New Delhi – 110020
India

About us

What we do

Where we work

MSF Websites

India

Our activities in 2023 in India

797

797

€16.4 M

16.4M

1999

1999

20,800

20,8

6,440

6,44

830

83

640

64

Explaining kala azar-HIV co-infection

Have you heard of kala azar?

Kala azar is a neglected but potentially fatal tropical disease. India accounts for 30 per cent of cases worldwide.

Better detection, diagnosis and treatment needed for neglected complication of kala azar in Bihar

Access to kala azar treatment in public healthcare system needs to be scaled up

Directly-Observed and Self-Administered Tuberculosis Treatment in a Chronic, Low-Intensity Conflict Setting in India

A step closer to effective treatment of severe acute malnutrition in Bihar

Infection control in households of drug-resistant tuberculosis patients co-infected with HIV in Mumbai, India

Five-Year Field Results and Long-Term Effectiveness of 20 mg/kg Liposomal Amphotericin B (Ambisome) for Visceral Leishmaniasis in Bihar, India

Contact us

80%

8%

15%

15%

5%

5%