How IT Can Help Address MDR-TB and Other Global Scourges

MDR-TB is an urgent, global threat with staggering human and financial implications. With two billion carriers worldwide, one person in ten will suffer from active TB and MDR-TB. Furthermore, improper diagnosis and treatment of MDR-TB is leading to increased cases of Extensively Drug-Resistant Tuberculosis (XDR-TB). In our highly interconnected world, M/XDR-TB has the potential to impact each of us from a health and economic perspective.

The 2009 Summit theme offers a powerful lens that reveals why we need to improve health systems globally. In a way, MDRTB is representative of the many challenges we face with other diseases&#8212HIV, malaria, and even chronic disease&#8212not only to drive prevention, but also earlier detection and effective therapies.

Technology can be a key enabler of improvements in disease surveillance, diagnosis, treatment monitoring, and prevention&#8212a transformative force that shifts the way care is delivered and how people can better manage their own health. Specifically, we can already rapidly leverage information technology to provide the following:

1. 1. broad, yet culturally sensitive education and awareness for patients, families, and communities;
2. 2. training for entry and mid-level practitioners on specimen collection, safer testing, and treatment;
3. 3. documentation and order entry to support logistics for improved drug and diagnostic test availability and distribution;
4. 4. patient compliance tracking; and
5. 5. centralized aggregation of data for epidemiology and research.

Imagine a rural village in Africa with a high incidence of active MDR-TB. Public health officials travel to the area and distribute laptops (such as OLPC1 or battery operated handhelds) to provide training for selected lay people. These devices, equipped with a lightweight electronic medical record, can catalogue patients and even perform biometric identity capture, which ensures proper matching between sputum samples and therapies. New advances in affordable light microscopy can capture images and transmit them to microbiologists for further analysis, if necessary. This same tool can be used to order medications from strategically located depots operated by governments, NGOs, and/or private organizations. Properly identified sputum samples can be transported from these depots for further analysis. Practitioners can also record Directly Observed Therapy, short-course (DOTS) and responses to therapy. Data can then be transmitted back to those same organizations for analysis and action.

In areas without access to cellular or mesh networks, more traditional “sneaker nets” can be used to transport flash memory cards to regional satellite uplinks. Furthermore, public health officials can use data on individuals with active TB to support appropriate quarantines and infection control. Finally, these same devices can play culturally-appropriate digital content to help patients and families understand TB and how to protect themselves and their community.

There are so many possibilities where technology can have an impact on decreasing the scourge of TB. Imagine this world. This technology exists today. Let us&#8212the public and private sectors&#8212work together to make this world a reality.

This essay is a part of the 2009 Summit Challenge – MDR-TB: Overcoming Global Resistance. To learn more about the 2009 Pacific Health Summit on MDR-TB, visit the Pacific Health Summit.