MSF has a number of long-standing projects in India, which we run in conjunction with the state authorities to address existing healthcare needs and emerging public health concerns.
We also run mobile clinics in remote areas of the country, where even preventable, treatable conditions such as malaria can assume life-threatening proportions.
Our teams are currently responding to the coronavirus COVID-19 pandemic in the country.
We provide medical and psychosocial care for people living with HIV and drug-resistant tuberculosis in and around Mumbai. In this city with 22 million inhabitants, around 50,000 people have TB, and 4,000 are infected with drug-resistant strains of the disease. We also offer specialised care for TB, HIV and hepatitis C in four clinics in the northeastern state of Manipur. From 2017 to 2019, we supported the Ministry of Health in Meerut city, Uttar Pradesh, to develop an effective, decentralised programme for diagnosing and treating hepatitis C. Kala azar is also endemic in India. It is particularly prevalent in Bihar, where we focus on addressing kala azar-HIV co-infection and providing holistic care to people living with advanced HIV.
A third of the world’s severely acutely malnourished children live in India, according to joint estimates by UNICEF, the WHO and the World Bank Group. Since 2009, our teams have treated over 17,000 children with severe acute malnutrition in India in the states of Bihar and Jharkhand, using an innovative community-based model. In Jharkhand, we treated nearly 1,000 children with severe acute malnutrition in rural and tribal areas in 2019 and conducted research. The results will be shared with policymakers and health workers to demonstrate a model for better identifying child malnutrition.
In the capital, Delhi, we provide medical and psychological care to victims of domestic and sexual violence, and raise awareness about the importance of seeking timely medical and psychological care. We work with community-based organisations, police, government protection agencies and the health ministry to highlight the clinic’s services and create an efficient referral system. We also engage the community in discussions on domestic violence, sexual assault and child abuse.
Since 2001 we have been offering counselling in Jammu and Kashmir, where years of conflict have taken a toll on people’s mental health. Our work includes raising awareness of the support available, reducing the stigma associated with mental health, and emphasising the importance of seeking assistance.
We have been investigating antibiotic resistance in Asansol district since 2015, where we also run community outreach initiatives promoting the importance of good hygiene practices, and the rational prescription and consumption of antibiotics.
Our activities in 2020 in India
Data and information from the International Activity Report 2020.
MSF works to fill some of the gaps in services for the most marginalised communities, including mental health support in hospitals in four districts of Kashmir. We also treat victims of sexual and gender-based violence in our clinic in New Delhi, where we provide round-the-clock, confidential services for people of all ages. When COVID-19 restrictions were imposed, we switched to phone-based counselling services and digital health promotion activities to guarantee continuity of care.
Treatment for infectious diseases
In our HIV centres in Manipur, we implement a model of care that is tailored to patients’ needs. We also support the antiretroviral treatment centre and inpatient management of HIV in a district hospital, and distribute food coupons and dry rations to homeless intravenous drug users.
MSF has been working with the government to increase access to holistic care for HIV patients with life-threatening opportunistic infections. In 2020, in Bihar, one of India’s poorest states, we focused on antimicrobial resistance stewardship to guide the prescribing and use of antibiotics. Palliative care, nutrition, mental health support and advocacy are also important components of our model of care.
In Mumbai, we continued to offer care for patients with drug-resistant tuberculosis (TB), with paediatric care a priority in 2020. The first patients were enrolled in the EndTB clinical trial using the new generation of drugs, aimed at finding shorter, more tolerable, injection-free treatments for multidrug-resistant TB.
Handing over projects
India has the world’s highest rate of childhood malnutrition, and in Jharkhand, one of the worst-affected states, MSF has contributed to shaping the treatment protocol. Although we discontinued our project providing community management of acute malnutrition in early 2020, we continued to follow up children with severe acute malnutrition discharged from the programme.
In 2020, we handed over to the health authorities the general healthcare services that we had been running via mobile clinics in the conflict-affected border areas of Andhra Pradesh, Chhattisgarh and Telangana states for 14 years.
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.
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