India has been battling tuberculosis for decades, with the disease claiming thousands of lives every year. Despite government efforts that have certainly yielded remarkable progress, there are still significant gaps in the TB care continuum with respect to accuracy and specificity of diagnosis, timeliness of treatment as well as efficacy of prevention. However, with the advent of new technologies, there is a glimmer of hope.
Globally, World Health Organization’s End TB strategy aims to reduce TB incidence by 80% and deaths by 90% by the target year 2030. India, however, has set ambitious goals for TB eradication, aiming to achieve a 90% reduction in TB incidence and 95% reduction in TB deaths by 2025.
Challenges
However, there are many challenges to achieving these goals. One major issue is that many TB cases go undetected or are misdiagnosed. Additionally, many people do not complete their treatment, leading to deterioration in their condition and development of drug resistance. Finally, there is a lack of access to quality healthcare for TB patients, including accessibility to point-of-care diagnostics and availability of trained healthcare professionals, particularly in rural and underserved areas.
Role of technology
Accelerating the pace of timely and accurate diagnoses is imperative and that’s where tech-led innovations can play a pivotal role in overcoming these limitations. For example, AI-powered algorithms can help diagnose TB more accurately and quickly than traditional methods like manual screening. This can be particularly useful in areas where there are few trained healthcare workers or where there are high rates of misdiagnosis. In addition, digital tools can be used to improve treatment adherence and track patient progress. Such innovations – which combine accuracy in diagnostics, facilitate easier accessibility among underserved communities and provide greater scope for individualised treatment – hold immense promise.
However, for technology to tackle TB, there is a critical requirement for patient capital to play a catalytic role in funding the development as well as the piloting and adoption of new technologies. Moreover, there is a dire need for close collaboration with the government so that innovations, once developed, are adopted in national health programmes and can achieve real, sustainable impact.
Applying the power of technology to address TB
Over the years, extensive research has led to where we stand today in the tuberculosis landscape. Diagnostic procedures for TB have undergone significant changes over the years – from traditional methods to the Nucleic Acid Amplification Tests (NAATs) and the widely accepted Active Case Finding (ACF) approach. However, robust diagnostic solutions that factor in diverse individual symptoms, and curating the appropriate treatment and care regimen is the need of the hour.
It is at this juncture that technology can intervene. The use of artificial intelligence, like cough reading AI algorithms for instance, can greatly aid the precision and speed of TB diagnosis and promote affordable and accessible care among underserved communities. The training of frontline healthcare professionals to efficiently utilise these tools for local communities can help patients manage their treatment journey better.
Tech-led diagnostic innovations can also strengthen the process of report generation, and subsequently, equip patients with appropriate treatment plans for their symptoms. These smart tools can also help ease the burden of healthcare workers and support local and national disease surveillance.
However, for such cutting-edge solutions to transform the TB care pathway, what’s missing is patient capital that could facilitate innovation development, drive evidence generation from the point of view of clinical validation, and catalyse pilot deployment to demonstrate the potential of population scale impact of these innovations. In addition to patient capital, the other missing cog is a seamless collaboration with the government to influence the scale of implementation.
Traditional as well as philanthropic funders can play an important role in addressing both these need gaps and finding such game-changing innovations. And in doing so, what these funders must look for is accuracy, affordability, scale, and long-term potential for impact. They should look for solutions that have been tested in real-world settings / low-resourced care environments and have shown positive results. Finally, they should ensure that these
innovations are aligned with the government’s priorities and strategies for TB eradication.
Strengthening collaboration with the government and the public healthcare ecosystem
Proactive collaboration with various stakeholders in the ecosystem has helped identify needs that are aligned with national TB priorities such as active case finding and sample transport.
Continued collaboration with and an early buy-in from the government is key for the success of these solutions, as it can help ensure that the innovations reach all those who need them.
Additionally, the public healthcare ecosystem can help promote the use of these tools and ensure that they are integrated into the existing healthcare system. For example, governmental support in encouraging proactive screening of patients using AI-based cough
screening can normalise and de-stigmatize the seeking of treatment at the initial stages, nipping the illness early in the bud.
Digital innovations can also strengthen the backbone of the national database by data liquidity through which, AI tools can parse raw data and generate specific insights that can be utilised by government stakeholders to strategise appropriate interventions. Furthermore, creating a strong feedback loop can significantly improve patient experience and knowledge sharing within the sector at large.
Conclusion
Looking to the future, tech-led innovations have tremendous potential to revolutionise the way we fight TB and strengthen healthcare in India. However, these tools are only as
powerful as they are accessible.
As we inch closer to the national and global TB elimination goals, we must ensure that we tap into the power of science and technology in bettering the TB care continuum and work collaboratively to ensure no one is left behind in accessing
these life-saving tools.
Views of the authors are personal and do not necessarily represent the website’s views.
Neetha Joy is a Director at ACT where she heads the ACT For Health portfolio and works closely with innovators, nonprofits and the public sector to accelerate the adoption of private innovations in public health. Prior to ACT, she has about 10 years of experience in investment banking and her most recently held position was as an Executive Director at Goldmans Sachs in the Securities division. Prior to GS, she worked at UBS as a fixed income salesperson in Mumbai and Singapore.
Madhav Joshi is Chief Executive Officer of India Health Fund – an initiative of Tata Trusts and the Global Fund which aims to help accelerate the control and elimination of communicable diseases by de-risking the development of technology-led solutions which can help improve outcomes in diagnosis, treatment and prevention, and strengthen primary care. Madhav was previously Pfizer where he led the Primary Care business in India, and has also led global innovation for Abbott Nutrition with a focus on emerging markets. Madhav is an alumnus of Shri Ram College of Commerce, University of Delhi and IIM, Calcutta.
Madhav Joshi is Chief Executive Officer of India Health Fund – an initiative of Tata Trusts and the Global Fund which aims to help accelerate the control and elimination of communicable diseases by de-risking the development of technology-led solutions which can help improve outcomes in diagnosis, treatment and prevention, and strengthen primary care. Madhav was previously Pfizer where he led the Primary Care business in India, and has also led global innovation for Abbott Nutrition with a focus on emerging markets. Madhav is an alumnus of Shri Ram College of Commerce, University of Delhi and IIM, Calcutta.
