Our work in India began more than a decade ago with an HIV prevention initiative. Since then, our health efforts in the country have expanded to include maternal and child health, nutrition, vaccines and routine immunization, family planning, and control of selected infectious diseases.

Maternal, Newborn, and Child Health

The Challenge

India has made significant progress in improving maternal and child health over the past decade, but each year it still loses more than 50,000 mothers due to complications related to pregnancy and more than a million babies under age 1. More than 95% of these deaths could be prevented with access to good healthcare.


The Opportunity

We believe that improving maternal and child health is the key to ensuring that India's poorest families and communities can benefit from the country's economic growth. India has made great progress in expanding healthcare resources, training physicians and nurses, developing production capabilities for a wide variety of drugs, and building a globally recognized technology sector. It is therefore well situated to accelerate improvements in healthcare for mothers and children by scaling up proven solutions—including prevention and treatment of newborn and postpartum conditions, prenatal care, hospital-based delivery, immediate and exclusive breastfeeding, and improved routine immunization.


Our Strategy

The Indian government has set national standards for maternal and newborn care and is strengthening the quality, accessibility, and affordability of primary care services. We support these efforts by providing technical assistance and financial support to expand community health worker training, establish monitoring systems, develop the healthcare workforce, and identify new technologies that can improve public health.

Immunization

The Challenge

One in five babies born in India dies before age 5 due to ailments that can be prevented through the use of safe and effective vaccines. Vaccines are among the most cost-effective health interventions ever developed, and they can save millions of lives each year.


The Opportunity

India can greatly reduce child mortality by strengthening existing vaccine delivery systems and thoughtfully introducing new vaccines to prevent high-burden diseases such as diarrhea and pneumonia, which together account for more than 30 percent of India's child deaths under age 5.


Our Strategy

India's vast pool of technical expertise and track record of collaboration among public, private, and nonprofit partners offer a huge research and innovation opportunity. We support the development of better and more cost-effective vaccines, and we work to expand access to vaccines and improve the vaccine delivery system.

Through our partnerships with the states of Bihar and Uttar Pradesh, we are working to improve routine immunization within broader maternal and child health initiatives.

Family Planning

The Challenge

When women have access to a variety of contraceptive methods, they are more likely to use them. But such access is not widely available in India. The unmet need for family planning services is especially high among adolescents and young women and among women in the poorest and most remote areas.


The Opportunity

Family planning has proven to be one of the most effective and affordable ways to improve the health of women and girls. Enabling women to make informed decisions about whether and when to have children reduces maternal and newborn deaths. It also increases educational and economic opportunities for women and leads to healthier families and communities.


Our Strategy

We provide strategic support at the national level and in the states of Bihar and Uttar Pradesh to help assess family planning needs, identify barriers to access and funding gaps, and provide technical assistance to improve the quality and availability of family planning services. We also support performance monitoring and better data collection, and we help improve coordination among governments and partners.

Our work includes engaging directly with private providers to offer access to quality family planning tools and services, and we work with community organizations and women's self-help groups to disseminate accurate information about family planning options.

Nutrition

The Challenge

India has one of the world's highest rates of malnutrition. Nearly half of the country's child deaths under age 5 are associated with malnutrition. Many Indian mothers begin pregnancy poorly nourished, which means they are at high risk of delivering underweight newborns, who in turn have an increased risk of illness, death, or remaining malnourished throughout life.


The Opportunity

Proven, cost-effective interventions are available to improve nutrition. By expanding their coverage, India can increase child survival rates and improve child cognitive development.


Our Strategy

We work with the Indian government to improve nutrition by demonstrating what is possible when existing interventions are delivered more broadly, and by supporting the development and use of new solutions. Our work involves partnerships at the national and state levels to scale up interventions that include focus on maternal nutrition, early and exclusive breastfeeding, complementary feeding, micronutrient supplementation, food fortification, and treatment of children with severe malnutrition.

Our nutrition efforts also include research and data collection to better understand the root causes of malnutrition, design more effective interventions, and track progress.

Tuberculosis

The Challenge

India accounts for one out of four cases of tuberculosis (TB) worldwide, and the disease kills nearly 1,000 Indians each day. TB disproportionately affects poor people, who account for about two-thirds of TB cases and experience devastating financial and social consequences.


The Opportunity

By improving diagnosis and treatment of TB, particularly by private healthcare providers, India can reduce transmission and strengthen disease control efforts.


Our Strategy

We focus on helping private providers improve the detection and treatment of TB and multidrug-resistant TB (MDR-TB), a form of the disease that is resistant to many TB drugs and is especially difficult and costly to treat. We also work on ways to bring private provider practices in line with national standards of care, improve diagnosis and treatment of TB and MDR-TB, and introduce support systems such as digital tools for TB surveillance.

Case Studies

HIV

In 2002, experts projected that the HIV epidemic in India could grow to staggering proportions, with more cases than in any other country. Given this dire prospect, we made our first investment in India that year: a US$200 million grant for an HIV prevention program called Avahan that was launched in partnership with community-based organizations and nongovernmental organizations.

Avahan focuses on sex workers and other high-risk populations in six states with the highest HIV infection rates. Since its launch, HIV infection rates in India have decreased dramatically. Over the years, the government has taken ownership of the program, as planned, and our efforts are now increasingly focused on working with vulnerable communities to expand services.

Avahan is one of the great success stories in national-level response to HIV. While HIV continues to be a challenge for the country, new cases have fallen to about 86,000 per year. The success of the Avahan partnership has led the foundation to collaborate in similar ways with Indian partners in other areas of health and development.


Polio

India’s certification as a polio-free country in March 2014 marked a major milestone on the path to global polio eradication. India was long considered the most difficult place to end polio due to its population density, high rates of migration, poor sanitation, high birth rates, and low rates of routine immunization. Huge numbers of unvaccinated children lived in crowded slums and remote rural areas. As recently as 2009, India was home to 50 percent of the world’s polio cases.

But the Indian government—with support from international partners, including the World Health Organization, UNICEF, USAID, Rotary International, and our foundation—rolled out a carefully coordinated polio campaign that sent out millions of volunteer vaccination teams to reach 170 million children each year with repeated doses of oral polio vaccine.

In 2011, the last case of polio was reported in India. In 2014, the country was officially declared polio-free, putting the world on course to completely wipe out polio within the next few years.