The World Health Assembly and United Nations’ Sustainable Development Goals include 90% reduction in TB deaths and 80% reduction in TB cases by 2030. In order to achieve these targets, more patients need to achieve higher levels of TB medication adherence and persistence. Directly Observed Therapy (DOT), the established standard of care for TB, is burdensome for patients and negatively impacts retention in care. Adherence monitoring technologies, potential alternatives to witnessed dosing, were prohibitively expensive and were inappropriate for TB medication formats or supply chains. As part of its ongoing efforts to modernize TB delivery, the Gates Foundation wanted to develop, evaluate, and deploy at scale more patient-centric, more affordable approaches to TB adherence monitoring and patient management.
We served as global project lead for the development, manufacture, testing, and deployment at scale of a highly accurate, highly affordable, TB blister-compatible medication adherence technology to improve patient adherence and to enable and inform differentiated care. The device, the Medication Event Reminder Monitor, or “MERM,” was developed and will be commercialized by South African-based Wisepill Technologies. The Arcady Group also coordinated with other grantees and public health organizations to plan and implement pragmatic trials and demonstrations of these medication adherence devices in China, India, and South Africa to support global scale up and thus support the broad implementation of proven-effective adherence interventions and dose history-informed differentiated care.