Eliminate tuberculosis among disadvantaged communities
Black and white photo of a sick woman in bed.

Operation ASHA (OpASHA) provides tuberculosis (TB) treatment to infected patients in India, Cambodia, and Lao through an extensive network of more than 200 centers. These centers are located in easily accessible places for patients (approximately a 10-minute walk) so as to maximize the likelihood of them continuing their treatment and to reduce the burden for patients associated with lost wages. Given the stigma commonly associated with TB which causes many cases to remain untreated, the centers typically have a neutral and unidentified façade. OpASHA additionally has a technology that allows the use of fingerprints to identify patients and keep an accurate log of their visits. This system ensures that all required doses are taken as prescribed and avoids both human data entry error and malicious data manipulation. Treatments are provided free of charge and typically last for a period of six months.

Tuberculosis: incidence and detection rates

Tuberculosis is an infection caused by a bacterium which primarily affects the lungs, but it can occur in any part of the body. Bacteria grow in the body and begin to destroy tissue with the potential to be fatal if left untreated. Those with weak immune systems are the most vulnerable so it is an infection closely associated with poverty.

 

The interactive visualization above shows the countries where OpASHA is working and TB data for the period 1990-2010 for these countries as well as for Low Income Countries, Middle Income Countries, and High Income Countries: (i) as expected, High and Middle Income countries have both the lowest incidence (per 100,000 individuals) and the highest detection rate, (ii) the incidence of TB range for 2010 was between 14 (High Income Countries) and 437 (Cambodia), (iii) the TB detection rate range in 2010 was between 85% (High Income Countries) and 54% (Vietnam), (iv) Cambodia has the highest incidence rate (even higher than that of Low Income Countries), and although in average it also has the lowest detection rate, detection rate has steadily increased over the years placing Cambodia ahead of India and Vietnam in this regard, (v) the incidence of TB in Vietnam is higher than that of Low Income Countries but the detection rate in the country has slightly decreased in the last few years being the country with the lowest detection rate among the analyzed countries, (vi) among all countries/regions analyzed there has been a steady reduction of TB incidence, but in several cases TB detection rate has also lowered.

A World Free of Tuberculosis

Two women sitting together.

OpASHA’s goal is 'A World Free of Tuberculosis'. First of all, it should be noted that TB is an infection that can, in most cases, be prevented and cured inexpensively by a combination of antibiotics over the course of 6 months, thus avoiding an evitable loss of human life. TB is free for OpASHA’s patients, and only costs OpASHA nearly $50 in recurring expenses.

Besides the obvious health benefits associated with eliminating TB, tuberculosis treatment provides economic benefits to both the patients and the national economy. The Government of India’ studies show that a person cured of TB earns an additional $150 every year. This generates an expansive effect: because a person is cured from TB now his family can also have access to better health, nutrition, and education. The loss to TB patients is an unbelievable $300 million per year, and the loss to the Indian economy due to TB is $23 billion annually. Additionally, it should be mentioned that given the proximity of OpASHA’s centers to rural and poor areas, these centers have also been used by other organizations to distribute food and clothing, and to bring emergency relief.

One of the biggest challenges that the world is facing is that of Drug Resistant TB, ie MDR, XDR and XXDR. MDR (Multi Drug Resistant) TB occurs because of incomplete treatment of the 'basic' or Drug Sensitive TB. Treatment of MDR is challenging and complicated. Treatment lasts for 2 years, medicines are toxic, side effects of medication are painful and can be life threatening, and the cost of treating MDR is astronomical. OpASHA is preventing MDR TB by empowering communities to ensure complete treatment. TB treatment centers are located in accessible areas, open at convenient times. Community health workers are selected for the areas they serve, to carry out education and tracking of patients who miss medication. OpASHA is using e-Compliance, ie biometric technology, to identify patients and track every dose taken, and this has brought down default to as low as 2%. Thus Operation ASHA is 'turning the tap off' on Drug Resistant TB.

As OpASHA clearly states it "in a nutshell, preventing and treating TB is a win-win solution for the patient, family, community, nation and the world."