Digital Adherence Technologies for TB: Translating Surveillance to Care

Abstract

Digital adherence technologies (DATs) have been deployed in India and are being scaled nationally with the goal of improving TB medication adherence and treatment outcomes. The governing principle of DATs is rooted in historical models of care that equated patient surveillance with care delivery in the treatment of TB. These forms of care delivery have evolved from directly observed therapy (DOT) to modern, sophisticated technology-enabled models of digital surveillance. The impact of this form of surveillance on patient adherence, outcomes, or any other dimensions of well-being is unknown and remains to be studied. Yet, the political economy of modern technologies render digital surveillance as an obvious solution to be taken up by governments for disease management. Here, the first large-scale implementation of the digital adherence surveillance models in India is examined in order understand the justifying rationale and the exact mechanism through which digital surveillance is translated to care for the TB patient.