This week, we bring you five social enterprises working for the containment and cure of TB and other endemic diseases. There’s good news and bad news to the tuberculosis story. The bad news: a third of the world’s population is infected with the bacteria, according to the Center for Disease Control. The good news: it’s curable. The World Health Organization reported an 87% success rate in curing TB through treatment. But the issue of access still remains.

Monday, July 12, 2010

Social Enterprise of the Day – Operation ASHA

India; Non-Profit

The back of every Mumbai rickshaw displays small reminders: “Don’t Spit! Spitting spreads TB!” and “TB is Curable. Use DOTS.” Many of Mumbai’s roughly 18 million residents likely see these service announcements, but far fewer follow their advice. Operation ASHA, a Delhi-based organization, hopes to change that. Operation ASHA works to extend treatment to slum dwellers in Northern Indian cities.  ASHA makes treatment easy to come by – locating their clinics in community shops or temples and keeping them open for long hours. They recruit trusted community leaders to administer the DOTS treatment (Directly Observed Therapy – Short Course) and spread important messages about TB prevention and treatment. But ASHA’s real innovation lies in their use of counselors – community-based full-time employees to walk a patient through treatment. ASHA provides commitment, not just a cure, and is working toward treating and de-stigmatizing TB throughout northern India.

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  1. Shelly batra, MD Said,

    July 14, 2010 @ 2:31 pm

    More about our work:-
    Operation ASHA is treating Tuberculosis in the slums of India, serving a population of 3.5 million slum-dwellers in six states and expanding rapidly. It has recently been elected to the Board of Stop TB partnership, an afilliate of WHO.

    Operation ASHA has taken TB treatment to the doorsteps of the disadvantaged. Treatment centers are established within the community, e.g. in small shops, huts and temples, so patients can procure the medicine conveniently, without wasting time or spending money on transport, or losing wages. Our highly trained counselors are responsible for tracking and eliminating default. In addition, Operation ASHA carries out intensive educational campaign and education camps. 80% of our funds are used for social mobilization and rest for delivery of treatment.

    Operation ASHA works very closely with Revised National TB Control Programme and uses drugs, hospitals and diagnostic facilities provided by it.

    Our model has achieved excellent results. In South Delhi where Operation ASHA is a major force, detection rate has increased by 78%. Default is down to 1%, thus Operation ASHA has ‘turned the tap off’, preventing MDR. Experts have found our work to be truly remarkable* and fascinating and excellent**.

    We practice stringent cost control. The cost of treating a patient for the entire therapy of average seven months is only $15. The government provides a grant so each center becomes self-sustaining within two years.

    “Operation ASHA’s DOTS centers serve as low-cost, efficient and accessible pipeline penetrating deep into the slums where government and other nonprofits have failed to reach”, said a management expert from McKinsey.

    We have tied up with MIT, which is conducting randomized control trials to assess the impact of Operation ASHA in slum communities. Research department of Microsoft has taken up development of bio-metric devices for us, to track each dose taken by each patient and further improve our results.We have partnered with the Prajnopaya Foundation, which is based in Boston and supports the vision of its chief patron, Nobel Laureate His Holiness the Dalai Lama. We are also discussing a partnership with another large international US based nonprofit.

    Having virtually eliminated default, established a cost-effective and replicable model, Operation ASHA is expanding rapidly. It plans to establish 1000 DOTS centers by 2012, which will serve a population of 70 million. It is looking for funding and partnerships to achieve this goal.

    * Ken Castro, MD, Assistant Surgeon General, USPHS, Director, Division of Tuberculosis Elimination, CDC, Atlanta, GA, USA

    ** Mario C. Raviglione, MD, Director, Stop TB Department (STB), World Health Organization, Geneva, Switzerland

  2. Rose Reis Said,

    October 13, 2010 @ 11:12 am

    I am very excited to be traveling to visit this program next week in Delhi. It is profiled on the Center for Health Market Innovations web site here:
    Very innovative.

  3. Shelly Batra, MD Said,

    October 14, 2010 @ 2:19 am

    Looking forward to meeting you, Rose.

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