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.

India

An MSF staff speaks with Anam*, a 17-year-old patient living with drug-resistant tuberculosis, and her mother outside the MSF clinic in Chembur. Mumbai, India, May 2023.

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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 2024 in India

Data and information from the International Activity Report 2024.

671

STAFF IN 2024 (full-time equivalent)

€15.2 M

15.2M

Expenditure in 2024

1999

Year MSF first worked in the country

MSF in India in 2024 In 2024, Médecins Sans Frontières (MSF) worked to address critical medical humanitarian needs among marginalised communities in India, who experience violence, neglect, exclusion, and healthcare disparities.

Country map for the IAR 2024.

In Bihar state, where there are limited treatment options and a high mortality rate for HIV, we cared for patients with advanced HIV disease. Our patients struggled with high costs of private healthcare before diagnosis, and suffered stigma after receiving their diagnosis. Working with the Bihar state Health Mission and Bihar state Department of Health and Family Welfare, we offered holistic advanced HIV care at Guru Gobind Singh hospital in Patna.

In Chhattisgarh state, despite an increase in violent clashes between government security forces and armed groups, we continued to run mobile clinics to deliver essential healthcare in remote areas, including safe abortion care. In 2024, we initiated a new mobile clinic in Hirmangunda, and collaborated with the Ministry of Health on a measles vaccination campaign following an outbreak.

In Manipur state, the situation remained unstable following an outbreak of inter-ethnic conflict in 2023, which posed challenges to the provision of care to our HIV and tuberculosis (TB) patients, and to the transportation of supplies.

In Mizoram state, we offered healthcare to refugees fleeing violence in Myanmar. At our clinic in Zokhawthar, we organised specialist referrals and delivered care in the surrounding area. We also provided relief items to newly arrived families in displacement camps.

In Mumbai, we handed over our project treating complex cases of drug-resistant TB to India’s National TB Elimination Program and the Brihanmumbai Municipal Corporation at the end of 2024. Since 2006, this project played a pivotal role in improving outcomes for patients who had no other treatment options.

In Jammu and Kashmir, where years of conflict have taken a toll on people’s mental health, we continued to provide counselling services.

In 2024

21,400

21,4

individual mental health consultations

6,780

6,78

people treated for malaria

1,040

1,04

people with advanced HIV under direct MSF care

290

29

people started on treatment for TB, including 190 for MDR-TB

An animated video explainer on the neglected tropical disease kala azar, and on kala azar-HIV co-infection. The video also explains the work MSF does on the disease in India. MSF has been focusing on the treatment of kala azar-HIV co-infection in partnership with the Rajendra Memorial Research Institute of Medical Sciences (RMRIMS) in Patna, Bihar since 2016. Until October 2018, MSF has treated over 700 co-infected patients.

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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"I barely had the physical strength to stand, let alone understand how I had not one, but three potentially fatal diseases. During my stay with MSF, I learnt about how the three diseases spread and how to take care of myself. I was treated for kala azar and tuberclosis and put on antiretroviral medication for HIV."
Zoya, who has been treated for kala azar-HIV co-infection and tuberculosis at MSF's ward in Patna, Bihar talks to Chavvi Kumar, Health Promoter at MSF.

MSF India

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India

India

Language

English

About Us

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MSF Websites

India

Our activities in 2024 in India

671

671

€15.2 M

15.2M

1999

1999

21,400

21,4

6,780

6,78

1,040

1,04

290

29

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.

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India

79%

79%

16%

16%

5%

5%