Notice B

Promoting the collaborative development of proposals for investments in digital health global goods

Notice B: Assuring the Long-term Value of a Critical Public Health Tool: e-TB Manager

Primary Author: Dai Hozumi

The emergence of drug‐resistant tuberculosis (DR-TB) around the world has made it more difficult to manage both individual patient cases and
ensure the uninterrupted availability of complex set of medicines needed to treat the disease[1]. Many national TB programs in low- and
middle-income countries still manage patient data with unsophisticated spreadsheets or even paper-based systems. As a result, although
standardized international guidelines for TB control exist, TB programs often have problems managing and analyzing the data needed to follow
these guidelines, which results in poorly timed treatment interventions.
In 2004 with funding from the US Agency for International Development (USAID), Management Sciences for Health (MSH) worked with TB
experts in Brazil to develop a software tool to tackle these increasingly complicated DR-TB program variables. The new tool—e-TB
Manager—combined the ability to monitor diagnosis, prescribing, and patient information with the information needed to ensure that TB
medicines were available for patients when needed. e-TB Manager version 2.0, upgraded in 2008, has expanded capacity to manage the
information needed by national TB control programs. It integrates data across all components of TB control, including suspected cases,
medicines, laboratory testing, diagnosis, treatment, and outcome and incorporates specialized data analytical tools, including cohort analysis.
USAID and other national and donor-supported programs have supported the implementation of e-TB Manager 2.0 in more than 10 countries,
where it supports the management of more than half a million patients. The tool is available in English, French, Russian, Spanish, Ukrainian,
Bahasa, Armenian, Portuguese, Romanian, Vietnamese, and Uzbek. The use of e-TB Manager has produced better data quality and timeliness,
which has reduced the number of supervision visits by 70%. Its built-in alerts have improved treatment adherence to maintain a DR-TB cure
rate of approximately 60%, while doubling case reporting. In addition, use of the tool has helped promote countrywide TB monitoring and
surveillance by allowing managers to identify high- and low-performing TB sites and targeting quality improvement interventions accordingly.
We propose to upgrade the e-TB Manager 2.0 by creating additional functions and interoperability with DHIS2.

Final Proposal: 
Application Status: 
In Scope - withdraw