The COVID-19 pandemic has been the worst public health crisis the world has experienced this century, causing extensive damage to human health and exposing gaps across health systems globally. With more than 45 million cases and close to 533,000 deaths by October 2023, India has been one of the worst-affected countries by the COVID-19 pandemic. Despite a large population, systemic-level limitations, and urgency, India not only managed the crisis, but was also a leader in guiding various aspects of the pandemic response.

By documenting the evolution of COVID-19 treatment protocols in India, we aimed to shed light on how government authorities considered, synthesized, and used local and global evidence, and how decentralized, state-level innovation were encouraged and scaled-up. Using qualitative approaches, we created a framework to map/inventory information presented in the COVID-19 treatment protocols and assessed presented information from a clinical management and public health perspective. Although the report focuses on aspects related to clinical management of COVID-19, it looks at it from a public health perspective. Our analysis considers administrative and procedural details for evidence-to-policy practice; highlights effective communication and dissemination strategies; and implications for broader use across other health areas. This report outlines learnings and best practices that would be useful for clinicians, policymakers, public health professionals, clinical and public health researchers, and risk communication specialists. This study was conducted through the Unitaid-funded, Population services International-led STAR Africa, Asia, Americas COVID-19 Preparedness project, implemented by PATH in India.