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Written by Nishant Halkarni and Rahul Doshi, Sensedose Technologies

Tuberculosis (TB) remains a disease of immense public health importance, inflicting significant socioeconomic costs on society. Despite being curable for decades and the remarkable strides made in innovations for newer diagnostic tools and drug delivery mechanisms, there is an urgent need to intensify efforts to dramatically reduce the TB burden. Achieving this goal requires all stakeholders to work in synergy and utilize available resources cohesively for effective TB control.

When we first entered the field of public health, one of the most striking observations was the deep-rooted stigma associated with TB. We were shocked to discover that in some cultures, TB is linked to witchcraft or seen as a curse on a family, often affecting multiple generations. This stigma leads to widespread discrimination against patients, even by those closest to them. The fear of discrimination often delays individuals from seeking help, resulting in more severe illness and a higher likelihood of infecting others. This perpetuates the misconception that TB treatment itself causes deaths, as delayed treatment is far less effective in advanced stages of the disease.

Stigma also discourages patients from adhering to their treatment regimens. TB medication regimens are long and demanding, lasting months or even years. The psychological toll of fearing discovery often outweighs the physical side effects of the medications, leading to irregular adherence and increasing the risk of developing drug-resistant TB.

Two years ago, we met a young engineering student who was also working part-time while battling multidrug-resistant TB (MDR-TB). His primary concern was whether he had exposed his family to the disease. He and his mother were devastated by the sheer volume of medication he had to take—11 different types, in varying quantities daily. The thought of months of treatment made him feel like he was fighting a losing battle. He lost his job, friends, and most of his close relatives. However, he became one of the first MDR-TB patients to use our device. We are proud to share that he completed his medication regimen with 95% adherence, passed his engineering exams, and now works at a civil engineering firm.

Women patients, in particular, often suffer from self-stigma, low self-esteem, shame, disgust, and guilt. This can lead to withdrawal from social interactions, the breakdown of personal relationships, and even risky behavioral patterns. For instance, in September 2019, we onboarded a patient who had recently married but was facing divorce due to her TB diagnosis. Another patient hid her medication from her in-laws, fearing eviction if they discovered her condition. In both cases, our discreet and modular TMEAD medication dispenser played a crucial role in helping them adhere to their treatment regimens.

Identifying adherence as a critical area for intervention, we collaborated closely with a diverse group of patients and staff from the National Tuberculosis Elimination Program (NTEP). After multiple iterations in design and functionality, we developed TMEAD—a smart, modular system comprising an application, a web dashboard, and a medication dispenser. Designed to blend seamlessly into a patient’s environment, TMEAD reminds patients to take their medication and has boosted adherence rates to 92%, enabling over 20 patients to fully recover.

At Sensedose Technologies, we believe in leveraging modular, scalable, and affordable technologies to improve the lives of TB patients. Our commitment to ending TB is driven by innovation, collaboration, and, most importantly, empathy for patients and healthcare workers. We have spent months understanding their challenges to optimize our solutions.

With the support of the India Health Fund (IHF), we are scaling our reach across district borders. The credibility associated with IHF has opened doors to agencies we once thought were beyond our reach. The IHF team has been instrumental in guiding us through regulatory barriers, providing the mentorship crucial for a young startup in the healthcare space.

On World TB Day, we are humbled by the progress we have made over the past year and motivated to work even harder in the years to come. Reaching every TB patient in India within the next two years is an ambitious goal, but we are confident in our ability to strive toward it. We also take this opportunity to reaffirm our commitment to supporting the Government of India in achieving TB elimination by 2025, as envisioned by our Honourable Prime Minister.