All-India Institute of Diabetes and Research

The All-India Institute of Diabetes and Research (AIIDR) seeks to improve access to diagnostic and preventive services for patients with hepatitis B virus living in rural areas of Gujarat State, India.


In 2009, Gujarat experienced a major hepatitis B virus (HBV) outbreak. The Indian Institute of Public Health in Gandhinagar (IIPHG) was one of the technical partners involved in controlling the outbreak and investigating causes of death to determine whether they were all hepatitis B-related.

Patients and their contacts were evaluated for HBV markers, and the majority were found to be positive. About 40% of the surveyed population had a history of injections one to six months prior to the outbreak, leading researchers to conclude that unsafe injection practices were involved.

Reviews of published studies from Gujarat revealed poor awareness about HBV and inadequate vaccination status among high-risk professionals including nursing staff and laboratory technicians.


AIIDR will receive $487,324 over three years to work with the IIPHG as a technical partner on a multi-level response to the HBV epidemic.

This partnership will:

  • Address failures and gaps in multiple systems that have allowed for epidemic outbreaks of HBV
  • Increase vaccinations and awareness of safe injection practices among healthcare workers
  • Enforce regulations proper handling of biomedical waste among the public and hospital staff

AIIDR and IIPHG will work together to implement a response that crosses multiple layers and sectors of the populations of Mehsana and Sabarkantha districts in Gujarat. Each district has more than 2 million people, the majority of whom live in rural areas.

Activities will:

  • Promote safe injection practices among healthcare practitioners and the general population
  • Document HBV markers in pregnant women and train healthcare providers in how to manage babies born to those women
  • Improve monitoring of biomedical waste disposal to ensure it adheres to national guidelines
  • Improve access to diagnosis, prevention and care for groups at high-risk of contracting HBV

Findings will be shared with policy planners to advocate for including HBV vaccines in communities affected by the disease. In addition, a sustainable plan for developing a network of nongovernmental organizations, trust and private hospitals will be developed to make facilities available for adult vaccinations.


  • Indian Institute of Public Health, Gandhinagar