Apollo & The Union, launch pilot program

A unique application will facilitate TB treatment adherence through SMS reminders, interactive voice calls and counseling services
An utility solution to curb rampant spread of the disease

Hyderabad, March, 2015: ‘The Union’ (International Union Against Tuberculosis and Lung Disease) in collaboration with the Apollo Hospitals, Hyderabad, is launching a pilot project to integrate TB treatment rendered in the private healthcare sector with the National TB Control Program through a unique web-based software application. This application facilitates improved tuberculosis notification, patient adherence to treatment and ensuring better outcomes.

The innovative software links the private health facility with Government of India’s TB notification portal Nikshay. It simultaneously supports TB patients for treatment adherence through messages, interactive voice calls and counseling services. The launch of this pilot project using the application to control and treat TB was announced by Ms. Sangita Reddy, Dy. Managing Director, Apollo Hospitals Group; Dr. Sarabjit Chadha, Project Director, The Union – India; Dr. Sai Praveen Haranath, Senior Consultant Pulmonologist, Apollo Health City; Dr Dilip Mathai, Dean, Apollo Institute of Medical sciences & Research; Dr. Lavanya Nutankalva, Consultant Infectious Diseases and Dr. Suneetha Narreddy, Consultant Infectious Diseases, Apollo Health City, at a Press Conference on Friday at Apollo Health City.

Tuberculosis is gaining epidemic proportions causing nearly 1.5 million deaths each year, mostly in developing countries. According to statistics available, India alone accounts for a fourth of the new cases of TB detected globally every year, India has 2.2 million new cases of the 8.6 million worldwide. This airborne disease kills about 1000 Indians every day and is therefore considered as India’s biggest health crisis. One of the reasons aggravating the rise in incidence is lack of integration of TB program with the private healthcare sector, besides let up on constant vigilance, effective surveillance and monitoring. Often patients reporting at private clinics or hospitals after initial relief from the disease are off the treatment radar, resulting in non-compliance of treatment, while that being the crucial period for vigorously follow up and monitoring. Such patients also end up spreading the disease in the community.

The World Health Organization (WHO) through its Stop TB Strategy, has been engaging relevant health-care providers through public-private and public-public mix approaches in tuberculosis care and control. Well known global organization working in this arena – The Union, in collaboration with theLilly MDR-TB partnership is implementing a project to systematically involve private health care providers in delivering effective and quality TB services in India.

As part of this initiative Apollo Hospitals is working on improving tuberculosis notification, adherence to treatment and bettering outcomes, in partnership with The Union and has launched a website – http: //www.ahtts.in/. The software linked with the Nikshay project, helps in reminding patients through regular SMS to take medicines, in addition, the Integrated voice response tool monitors the treatment adherence.

“Non-compliance to treatment increases the risk of drug resistant tuberculosis, which is a grave concern in India. Automated management will improve care and save lives. It is no more a question of can we eliminate TB – it’s more a call to action to definitively rid the world of this deadly disease,” says Ms Sangita Reddy. We are launching the pilot project today and will roll it out to other locations in the

coming weeks. She said, TB has a solution, but we being not in a position to control it is sad. Referring to TB prevalence in India, she said, the problem is large, solution is strong but public awareness is low and requested media to work towards increasing awareness levels. Apollo Hospitals is committed, we will run an active TB program. 70 % of the patients are falling out of treatment regimen, intervention through technology in the form of this application will ensure better adherence. The application will be test piloted and perfected at Apollo Hospitals, Jubilee Hills, before rolling it out to other Group hospitals subsequently, she said.

Dr. Sarabjit Chadha said, half of the TB patients are getting treated in private healthcare sector, often there is no follow up mechanism for these patients. This software captures essential details of such patients, notifies the patient’s ailment. It interacts with the patient constantly through daily SMS reminders for consuming the medication dosage, checks on his treatment adherence through IVR every third day and counselors at Apollo Hospital will talk on phone and visit if necessary those patients who are not sticking to the treatment protocol and counsel them to get back on treatment track. We will scale this program to other private hospitals who can replicate, on successful completion of this pilot project. He said, off-late TB diagnosis has been effective, however modern dwellings and crowding in urban centers is giving a fillip for TB to spread rapidly, while reminding of the saying ‘TB anywhere is TB everywhere.’ Also high incidence of drug resistance due to skipping of the treatment protocol is a cause for concern. He said, we are currently working on a shorter treatment regimen called STREAM (Standardized Treatment) Regimen for TB treatment, to bring down the treatment duration from the current two years to nine months. We have done pilot testing of this in Bangladesh and are currently treating TB patients in four countries, Vietnam, Mongolia, Ethiopia and South Africa, with this regimen with 85% cure rate. We would complete our trials and introduce it in India by 2016. He said, a couple of companies abroad have developed drugs to treat Multiple drug resistance, which are currently not available in India.

Dr. Sai Praveen Haranath said, any cough which doesn’t subside over a period of two weeks needs to be got checked. People may contract TB, which may remain dormant for extended period, but will become active when the immune system is weak or one is on drugs to suppress immunity. He said, the productivity loss on account of TB in India alone is estimated to be $25 bn.

Dr Dilip Mathai said, TB is a chronic ailment, often patients report to doctors late, diagnosis is easy and if one takes medication can be cured in six months in 98% of the cases.

About Apollo Hospitals

It was in 1983, that Dr. Prathap Reddy made a pioneering endeavour by launching India’s first corporate hospital – Apollo Hospital in Chennai. Now, as Asia largest and most trusted healthcare group, its presence includes 8,488 beds across 51 Hospitals, 1,586 Pharmacies, 92 Primary Care and Diagnostic Clinics, 100 Telemedicine units across 10 countries. Health Insurance services, Global Projects Consultancy, 15 colleges of Nursing and Hospital Management and a Research Foundation with a focus on global Clinical Trials, epidemiological studies, stem cell & genetic research and the first Proton Therapy Center across Asia, Africa and Australia.

In a rare honor, the Government of India issued a commemorative stamp in recognition of Apollo’s contribution, the first for a healthcare organization. Apollo Hospitals Chairman, Dr. Prathap C Reddy, was conferred with the prestigious Padma Vibhushan in 2010. For more than 28 years, the Apollo Hospitals Group has continuously excelled and maintained leadership in medical innovation, world-class clinical services and cutting-edge technology. Our hospitals are consistently ranked amongst the best hospitals globally for advanced medical services and research.

About the Union

The mission of International Union Against Tuberculosis and Lung Disease (The Union) is to bring innovation, expertise, solutions and support to address health challenges in low and middle-income populations. Headquartered in Paris, The Union is the only international voluntary scientific organisation with partners providing a neutral platform to fight TB, HIV, asthma, tobacco and lung disease.

Established in 1920, The Union today is both a non-profit institute with five scientific departments and several offices worldwide; and a federation of close to 3,000 organisations and individuals. Its scientific departments focus on tackling major health challenges including: Tuberculosis, HIV, Lung health (including Child Lung Health), Non-communicable diseases, and Tobacco Control. Technical assistance, research, education and advocacy form the core of The Union’s activities and support to more than 170 countries and programmes across the world.

The Union is most widely known for developing the DOTS (Directly Observed Treatment, Short Course) strategy for treating and controlling tuberculosis. Internationally recommended and adopted by the World Health Organization, The Union model has been used to treat 37 million people around the world. For more information, please see www.theunion.org.

About The Union South-East Asia

The Union South-East Asia Office (USEA), based in New Delhi, works in Bangladesh, India, Indonesia and other countries across the region, drawing on a network of consultants and strong partnerships with governments, civil society, corporations and international agencies. Established in 2003 as The Union’s first regional office, today it brings global experience and expertise to its work as well as efficiency and energy to The Union’s services across the region. USEA has a dedicated staff with technical expertise which reflects the Union’s emphasis on tuberculosis, HIV, lung health, tobacco control, non-communicable diseases and research.

Since 2009, USEA has managed Project Axshya, a Global Fund supported project designed to enhance access to TB services by vulnerable and marginalised populations in 300 districts across 21 states of India. Other key projects include tobacco control efforts in India, Nepal and Bangladesh through the Bloomberg Initiative to reduce tobacco use; and the Eli-Lilly supported project to expand sustainable TB control in India. USEA also coordinates trainings to build capacity in the management of TB and MDR-TB, operational research, programme management and other skills.