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TEDxWBG: Scaling Up Services, Together We Can Eliminate TB

Dr. Shelly Batra's picture

This bag belongs to Rinki. Rinki doesn’t need it anymore. She was thrown out school when she got tuberculosis. So this is tuberculosis or TB, as it’s commonly known. Though fully curable disease, it has now become a global pandemic. There are nine million new cases in the world annually. 1.3 million deaths. Ten million children have been orphaned because of it. Today itself, 5,000 people will die of TB. And TB is curable.

Let’s talk about technology. eCompliance is a low cost solution to tracking the progress of TB treatment. A tablet with a fingerprint reader attached, a patient gives their fingerprint on each visit to the treatment center. If the fingerprint is messed, an immediate alert goes to the health worker, who visits the patient’s house to give the medicine and takes the fingerprint as proof of visit. This ensures that every dose is taken and prevents drug resistant TB. The World Bank Group’s India Development Marketplace played a crucial role in scaling our eCompliance system and upgrading it to a zero text application. The zero text application is being used by illiterate health workers across the world with ease and accuracy.

Operation ASHA has succeeded in scaling. We have gone beyond oceans, but there have been many challenges. When we first started, there was no awareness about TB. While the disease has remained, TB was considered to be eradicated years ago. This means there were no funds allocated specifically for this disease. But we persevered. Because of the lack of funds, we made our organization highly cost effected and dedicated ourselves to producing results not just processes. I believe in measuring impact and outcomes and it has been a core philosophy of Operation ASHA from the beginning.

Many things enabled us to scale. The first is that we had a replicable model at a low cost. Operation ASHA’s cost of detection and treatment per patient is only US $80, several times less than others. The tech is simple and can be modified for any geographical area or language, and can be upgraded to add any other condition that needs monitoring. But most importantly, we extensively work with local communities, we understand their challenges, create jobs for disadvantaged people and train them for TB treatment and in other health issues.

We started with one center. Now, Operation ASHA serves six million people in nine states across India. In Cambodia, we serve 10% of the population and soon, we will be treating 25% of all TB patients. In addition, our work has been replicated in Uganda, the Dominican Republic, and Kenya, and we are in discussion with many other countries. While that is because of our model, we must remember that it is also because TB is spreading like wildfire! It has even reemerged in the west, in the US and the UK, from where it had already been eradicated.

TB is not an ancient problem, it is a contemporary disaster. Let us see the writing on the wall. Unless we act now, TB will become the next plague that will wipe out millions. This is the war we are fighting, a war against disease and poverty. We must dedicate resources and allocate funds now.

Each one of you who is listening to this talk, every one of you is important. Together we can and will eliminate TB. Together, the fight goes on, and Rinki is back in school again.

Dr. Shelly Batra delivered this speech at the 2014 TEDxWBG "Ending Poverty" held at the World Bank Group's headquarters in Washington, D.C. on October 9, 2014. For the full speech as well as other inspiring stories from the day, see the TEDxWBG website.

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