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OperationASHA | India
$897,324 | Stage 2: Testing at Scale | Global Health
The problem: Patient lapses in tuberculosis treatment plans
Globally, tuberculosis (TB) is responsible for 1.4 million deaths a year. It is second only to HIV/AIDS as the most deadly infectious disease worldwide. Drug resistant strains are a major obstacle to reducing TB deaths. While tuberculosis (TB) can be cured in nearly all cases, it remains the leading infectious cause of death among adults in India, where nearly 2 million people develop TB annually and 1,000 people die from the disease each day. MDR-TB is widespread and much more costly and difficult to treat than regular TB. Curing one patient of MDR-TB costs as much as curing 200 patients of non-resistant TB.
Patient lapses in first-line TB treatment are a key cause of MDR-TB. The international standard in TB treatment requires the drug regimen to be taken in the presence of a healthcare professional for 6 to 8 months. This requires frequent trips to obtain treatment, which can be very costly for patients, both in terms of transportation and lost income due to missing work. As a result, many patients stop treatment, which puts them at risk of developing MDR-TB.
The solution: Using fingerprint technology to track patient progress
Operation ASHA uses eCompliance to combat MDR-TB by reducing patient lapses in treatment. Developed in collaboration with Microsoft Research, eCompliance registers the presence of patients and staff at treatment centers through fingerprints, and sends daily text message updates on patient attendance to counselors and program managers. eCompliance empowers health professionals to provide targeted counseling to TB patients who lapse on their treatments thus helping reduce the spread of MDR-TB.
An initial pilot of eCompliance in urban slums in Delhi reduced rates of treatment default to below one percent. Now Operation ASHA is using DIV Stage 2 financing to carry out a randomized control trial of nearly 8,000 patients in India and Cambodia to provide rigorous evidence on the cost-effectiveness of biometric tools like eCompliance on a large scale.
The potential: Impacts, cost effectiveness, and implications
A cost-effective system for improving patient compliance is a critical step in preventing the spread of MDR-TB. Early results show promising evidence that biometric tools are able to provide such a solution. By demonstrating cost-effectiveness at scale, Operation ASHA will be able to provide a clear roadmap for other countries to treat the 310,000 cases of MDR-TB that occur globally each year.
For the latest OperationASHA updates, visit their website.
Last updated: October 15, 2013