Providing medical care for drug-resistant tuberculosis in Mumbai

© Atul Loke/Panos Pictures

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.

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 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.

DRTB patients initiated on treatment
DRTB patients cured and completed their treatment with new drugs (BDQ/DLM)
Paediatric DRTB patient initiated on treatment
Patients initiated on new TB drugs (BDQ/DLM)
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