Jahangeer shared with the delegates of the world conference some of the key learnings from HPPIs experiences of working with unhoused persons in India since 2017.
Timeless wisdom of Margaret Meads words come to life when we hear Jahangeer speak: "Never doubt that a small group of thoughtful committed individuals can change the world. In fact, it's the only thing that ever has."
HPPI implemented 7 initiatives during 2017-2025 to find more TB among the unhoused persons in Delhi, India and link them to public services. HPPI developed a person-centred, rights-based, and gender transformative model to do so. There were estimates that the number of unhoused persons in Delhi could be around 300,000.
During 2017-2025, frontline healthcare workers of HPPI reached out to 225,022 unhoused persons who were highly vulnerable to TB and hard to reach. Out of those screened for TB, 10,976 people were found with presumptive TB and offered a (free) confirmatory TB test in government facility. 2283 unhoused persons were found to have active TB disease and 53 of them had a very serious form of TB, referred to as drug-resistant TB (where TB bacteria become resistant to some of the most powerful anti-TB medicines).
Overall, for every 99 unhoused persons screened for TB, 1 was found with active TB disease between 2017-2025 by HPPI. However, in some areas or projects, this rate was alarmingly high: 1 in every 44 screened for TB had the disease.
Making a difference
When HPPI began working with unhoused persons in 2017, a lot of them dropped out of care. 15% was the loss to follow up rate. And dropping out of lifesaving TB treatment meant that the person continues to suffer, has higher risk of TB death, and the disease keeps spreading to others (if the person had lung TB). Death rate among the unhoused peoples in 2017 who were on TB treatment was 8.8%.
HPPI model demonstrated that it is possible to reduce human suffering and save lives: loss to follow up rate dropped to 1.7% by 2024 (from 15% in 2017), and TB death rate dropped to 2.5% by 2024 (from 8.8% in 2017).
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