Despite recent diagnostic advancements, undiagnosed and mismanaged tuberculosis (TB) care continues to result in the spread of TB and drug-resistant TB throughout the world.
New technology is needed to help deliver proper TB care to those patients who need it most. The development of innovative solutions will ultimately have a positive impact on efficient patient care and help achieve the TB elimination targets set by the global community.
USAID and IKP Partnership for Innovation
The United States Agency for International Development (USAID), IKP Knowledge Park (IKP), and the Gates Foundation are working together to identify, fund, and nurture technology-driven solutions that will assist in achieving a world free of TB. The program, titled “Innovations for TB Control,” seeks innovative projects through a crowdsourcing approach in three identified areas:
- Treatment adherence through the use of information and communication technology
- Diagnostics
- Models for public-private engagement
The First Call under Grand Challenges for TB Control (GC-TBC)
The first call for proposals under the GC–TBC was an initiative to encourage and nurture innovation to better address TB treatment adherence through the use of information and communication technology. Projects could include ways to monitor compliance with treatment regimens; methods for incentivizing patient to follow treatment regimens; and ways to integrate treatments with other services offered by healthcare providers. The first call involved identifying 15 awardees during Phase I and 4 awardees during Phase II.
Phase I of the first call was executed in the following order:
- Launching of a request for proposals and awareness generation
- Selection and due diligence of shortlisted proposals
- Recommending of up to 15 proposals for funding of US $30,000 each
- Mentoring of the 13 funded candidates for a period of 6 months
For Phase II, 4 out of the 13 awardees were identified and given additional funding (of up to US $100,000) to integrate their solutions with the public and private healthcare systems in India.
The four innovative projects selected under Phase II of Call I are:
- Holistic TB Drug Adherence System Using Mobile Phones Augmented with Smart Hardware Apps
Location: Pune, Maharashtra, India
Primary Investigator: Nishant Kumar, Embryyo Technologies Pvt Ltd
Nishant Kumar and team are building a mobile hardware device that can serve as an electronic pill box and can be attached to a conventional mobile phone. An application running on the mobile phone controls the hardware attachment via Bluetooth. The mobile hardware and app can track each and every pill of a pre-coded blister pack and can record the timestamps at which the individual pills were taken. This product uses a novel points-based incentives system to encourage patients to continue adherence to their treatment by rewarding them each time they take their daily medication. A complementary mobile phone application also runs on the handheld device of a health worker, allowing him/her to keep track of treatment adherence in tandem with the patient.
- 99DOTS: Using Mobile Phones to Monitor and Improve Adherence to Tuberculosis Medications
Location: Bangalore (Karnataka) and Patna (Bihar), India
Primary Investigators: Bill Thies and Andrew Cross, Everwell Health Solutions Pvt Ltd
Bill Thies and the team of 99DOTS aim to achieve 99 percent TB drug adherence using a combination of basic mobile phones and augmented blister packaging to provide real-time medication monitoring at a drastically reduced cost. When a patient dispenses medication from the blister pack, the pills also break through perforated flaps on the blister card. On the back side of each flap is a hidden number, which patients then submit using their mobile phone as evidence that they have dispensed medication. Using this system, patients also receive a series of daily reminders via SMS and automated calls. Missed doses also trigger SMS notifications to care providers, who follow up with personal, phone-based counseling. Real-time adherence reports are also made available on the Web.
- mDOTS—Integrated TB Platform with Mobile Connectivity for Active Compliance
Location: New Delhi, India
Primary Investigator: Mr. Hilmi Quraishi, ZMQ Development
Hilmi Quraishi and team are building a system to enable adherence to TB treatment. The proposed solution is based on ZMQ’s Open and Universal Technology-based TB (OUT-TB) Management and Treatment Framework, developed under its Freedom TB initiative. The solution is based on a bottom-up technology model that empowers patients to take control of treatment with reminders systems, compliance reporting, dosage tracking, test scheduling, and connections to providers for need-based supervision. The solution will also create new networks of treated patients who will serve as peer-educators in communities to provide support to patients in their communities.
- myTBdoc Program
Location: New Delhi, India
Primary Investigator: Mr. Nakul Pasricha, Pharmasecure Product Authentication Services India Pvt Ltd
Nakul Pasricha and team are working to develop special cards called myTBdoc cards with unique alphanumeric identifiers printed on them that correspond to unique identifiers printed on TB medicines manufactured by Lupin, a manufacturer that holds a major market share in the Indian TB drug market. Medical representatives will give myTBdoc cards to private doctors that see TB patients, educating them on correct TB prescription methods. Doctors will give these cards to new TB patients, instructing them to SMS the unique code on the card to enroll them in the program. Patients will then SMS the unique codes printed on their TB drugs as they take them. PharmaSecure will also provide patients with reminders to take medicines, follow up calls, and TB health tips via SMS and voice calls.
As these innovative, technology-based solutions to TB-care adherence begin to be implemented, there is great hope that these interventions will reach a wide sector of the population and curb TB rates in India.
Looking Ahead: Second Call under GC-TBC
Building on the success of the first call under GC-TBC, the second call seeks to identify and fund the creation of validated, sustainable solutions for screening, detection, and diagnosis of TB that are specifically designed to work well in an Indian context. The call ran from May–June 2015, and awardees will be chosen soon. Learn more.
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