HPPI’s TB intervention is providing treatment and assistance among the homeless people of Delhi

The disruptions in TB services since the pandemic started has led WHO to warn that even by a conservative estimate, the COVID-19 crisis could set the world back to the levels of TB mortality that it saw 5 years ago.

India has the highest burden of TB in the world, accounting for about a quarter of the global TB burden. While the Indian government was pushing to end TB in the country by 2025, the ongoing crisis has clearly thrown a spanner in the works.

In the light of these developments, it has become increasingly crucial that the TB medication of the existing patients must continue uninterrupted.

HPPI has a long experience of working in the area of facilitating TB treatment, particularly in the vulnerable population – including the homeless – of the National Capital region. Between December 2017 and October 2019 Azim Premji Philanthropic initiative (APPI) supported HPPI’s Homeless Resource and Service Centre project under which 24,500 homeless people received TB related services which included symptomatic screening and testing, and treatment initiation at the local state-run chest clinics.

Since then, the project has continued to operate with a limited staff strength to ensure continued treatment of the ongoing TB cases. 

“With the announcement of the nationwide lockdown, it became quite clear that our team would have to put in extra effort to secure that the treatment of the patients continued without any hinderance,” says Hari Prakash, TB project leader.

“As the movement of people came to a standstill, we stepped up our coordination efforts with the patients and the DOTs centres,” he says referring to the Directly observed treatment, short-course, a WHO-recommended TB control strategy where patients can get their regular dose of medications.

Since the APPI-supported project came to an end, HPPI’s TB project has ensured continued treatment of 86 TB patients through one-to-one sessions, group counselling and improved access to the chest clinics. Out of the 86 patients, 58 have successfully completed their treatment. Priority care is given to Drug-resistant TB patients, co-infected, repeated lost-to-follow up cases, people addicted to drugs and alcohol, children (below 14 years) and women TB patients.

“Our main task has been to ensure that there is no lapse in medication of the patients. For this we have continued to stay in contact with all the identified patients and their families in our intervention area,” says Hari, explaining the work done by his team during the ongoing pandemic.

“In cases where frequent movement of the patients or their family members to the DOTs centre was not possible, our team coordinated with the centre in-charge to secure access sufficient medicines to last the patient a longer duration.”

Since the lockdown restrictions were relaxed, the team has been conducting more frequent visits to the patients for providing requisite counselling and information sessions about COVID-19 and TB.