The Indian government has increasingly used technology to aid its fight against tuberculosis (TB). By using biometric and mobile technology, it has been able to better ensure that patients take their proper treatment. This mitigates the risk of spreading the disease and developing into multi-drug resistant TB.
For a disease that kills more than 270,000 people in India and a few million worldwide in other countries, developments in the fight against TB have been slow to come. The vaccine that is currently being used to prevent TB is more than 85 years old and is only effective against certain strains of the disease in children. The most widely used diagnostic test was created 125 years ago and misses half the cases. It also cannot detect strains of TB that are resistant to drugs.
India passed a law in 2012 that made TB a notifiable disease, which means that doctors are required to report an infected person to the government. To make the process easier, the government has rolled out a program called Nikshay in private and public hospitals. Nikshay is an electronic reporting unit that uploads case files and treatment processes onto a single database across the country. This makes it easier to track people who have contracted the disease and ensure that they are taking the proper treatment.
In some places, Nikshay has been compounded with Aadhar, a biometric identification system that was rolled out a few years earlier. Aadhar gives every Indian citizen a unique number that is linked to a biometric card. Coupling the data in Nikshay and Aadhar improves monitoring and evaluation, and makes payments easier as Aadhar can also be linked to a bank account.
Treating TB is a long and complicated process. Estimates show that fighting TB can amount to 39% of a household’s annual expenditure. An infected person needs to take 13-17 pills daily for six months. If he stops his treatment before the proper time, he runs the risk of developing multi-drug resistant TB, a more virulent and difficult-to-treat form of the disease.
Some state governments in India have begun to use the SIMpill, which was originally implemented in South Africa a decade earlier, to ensure that the treatment process is completed correctly. It gives patients pre-programmed medicine bottles that are able to monitor whether pills are taken at the right time in the right amount. Each time the bottle’s cap is opened the central server is notified. If there is a discrepancy or a missed dosage, the patient and caregiver receives a reminder text message on their phone.
In another innovative use of mobile technology, some states have rolled out the Mobile Technology for Community Health program, which sends patients SMS reminders about appointments, treatments and health tips. The central government has also initiated the Missed Call Campaign, in which a person can give a toll-free number a missed call and have someone call them back to answer their questions.