UPDATE
Médecins Sans Frontières (MSF)/Doctors Without Borders has announced the planned closure of its Mumbai-based Drug-Resistant Tuberculosis (DR-TB) project by the end of 2024. This significant initiative has been providing comprehensive care to patients with complex cases of extensively drug-resistant TB (XDR-TB) since 2006. The project, which has played a pivotal role in treating patients who had no other treatment options, will be handed over to India’s National TB Elimination Program (NTEP) and the Brihanmumbai Municipal Corporation (BMC), ensuring that the fight against TB in the region continues with sustainable support.
In 2016, MSF partnered with NTEP to co-manage the DR-TB center at Shatabdi Hospital, located in one of Mumbai’s high-burden areas, the M-East ward. This partnership was instrumental in improving diagnosis, patient care, and treatment success rates. 7,431 DR-TB patients were enrolled as part of this collaboration and treatment success rates increased significantly, from 62% in 2016 to 80% in 2024.
MSF will continue to advocate for improved access to TB treatments, especially for children, and for shorter, all-oral regimens that are critical for patients with limited treatment options. MSF will continue engaging with local organizations, healthcare workers, and TB survivors to ensure that the progress on DR-TB is sustained in the long run. MSF remains committed to supporting NTEP and other stakeholders in addressing the ongoing gaps in TB care. MSF’s presence in the global fight against TB will remain strong, as the organisation continues to work towards innovative solutions for the millions affected by this preventable and curable disease.
MSF’s other projects in India include the provision of comprehensive care to people living with advanced HIV in Bihar, essential healthcare in remote areas of Chhattisgarh, specialist care for HIV, TB, Hepatitis in Manipur, and mental health services in Jammu and Kashmir.
What We Do
MSF provides free, comprehensive and individualized treatment at its independent clinic in Mumbai to people with severe forms of Drug resistant Tuberculosis (DRTB). Patients seen by MSF have previously been treated with ineffective regimens for several years by public and private practitioners. Some are believed to have been directly infected in the community by extensively resistant strains.
MSF also supports DRTB diagnostics and treatment at Public DOTS plus centre in Mumbai east ward in collaboration with National Tuberculosis Elimination Programme.
- Maharashtra
India has the world’s highest burden of TB. As per the 2021 WHO Global Tuberculosis report, India accounts for 26% of global cases, which is more than double the burden of the next country, China (8.5% of global cases). India accounted for 34% of global TB deaths (with 300,000 deaths projected each year i.e. over 800 per day). Limited national surveys estimated multi drug resistance levels of 3% among new TB cases and 12-17% among previously treated cases.
Emergence of MDR and XDRTB has become a major public health problem in India.
In 2023
MSF continued providing treatment to a complex cohort of DR-TB patients referred from across Mumbai. Additionally, MSF offered support in basic palliative care to a limited number of DR-TB patients. The diagnosis of TB in paediatric cases was strengthened especially among malnourished children by using newer sensitive molecular diagnostic tools as recommended by World Health Organization (WHO). Projects operational research on ‘digital support technology for treatment
adherence’ and ‘contact tracing’ was presented in The Union World Conference on Lung Health 2023 in Paris.
In 2021
The National Tuberculosis Elimination Programme (NTEP) of India updated treatment guidelines, creating access to more effective, all-oral regimen for patients with drug-resistant TB. Due to COVID-19 and associated restrictions, DRTB services were modified. Virtual consultations and counselling sessions were done and medications were delivered to patient homes. MSF provided support to increase the COVID-19 vaccination coverage among DRTB patients in MEW and MSF clinic.
Paediatric DRTB services were improved with a focus on child friendly services. The project developed and implemented pediatrics counseling guidelines and set up dedicated consultation days, while exploring improved child friendly diagnostics tools and access to paediatric formulations. Patient enrolments under end TB (MDR TB FQ sensitive patients) clinical trial was completed after enrolling 34 patients. Patient enrolments for endTB-Q (MDR TB patients resistant to FQ) is ongoing and 74 patients enrolled in 2021.
For HIV DRTB patients, comprehensive care is being provided in collaboration with Anti-retroviral treatment (ART) centres. For Diabetes mellitus (DM) DRTB patients, close monitoring is being done with regular testing for HbA1C. We are also providing and exploring other comprehensive care models for DRTB patients requiring palliative care.
