Mishra assumed his current position in 2020. The group operates in Egypt, Kenya, and Nigeria with four healthcare facilities comprising over 1,000 beds as of June 2026. In 2026, it entered Kenya with a new clinic, began developing a new hospital in Saudi Arabia, and partnered with Siemens Healthineers to advance oncology treatment in Egypt. In February 2026, Alameda completed a $190 million minority investment agreement with Development Partners International. Mishra was previously regional director at Max Healthcare, India.