The pandemic triggered by novel corona virus has affected humanity across the world in more ways than one. It has not only challenged the medical fraternity but has also had an adverse effect of the gravest kind on the economy of even some the most advanced countries. India, a developing country, too had its share of challenges. Amid the medical crisis, a need arose to look into areas that needed persistent focus and attention to prevent and contain other life-threatening/chronic diseases/illnesses. J& J, one of the reputed healthcare organisations, stepped in to reach out to those suffering from Tuberculosis. And since TB patients are more vulnerable and are at a greater risk of contracting COVID-19, J & J initiated the ‘QuickFire’ challenge that aims at providing hassle-free medical assistance to the drug-resistant tuberculosis patients.
Among the many awardees of J & J’s special grant for the pilot projects, Doctors for You and ZMQ Global find a mention. This project was initiated to reach out to those patients who were more prone to COVID-19 and were at a greater risk of developing severe complications.
LSW learnt more about the Quickfire challenge from J & J’s spokesperson Dr. Vandita Gupta, Head, Infectious Diseases & Vaccines at Janssen India, the Janssen Pharmaceutical Companies of Johnson & Johnson.
Dr Vandita Gupta-Head, Global Public Health, Infectious Diseases & Vaccines AND Metabolics
Click here to view profile
LSW: When was the Quickfire Challenge initiated and what was its purpose?
Dr. Vandita Gupta: In 2019, TB was the world’s deadliest infectious disease, claiming 1.4 million lives – over 4,000 people a day. Growing resistance to the most powerful TB medicines was compounding this challenge, with approximately half a million people developing drug-resistant TB (DR-TB) last year. And this was all in a pre-COVID-19 world.
The COVID-19 pandemic has presented new challenges and concerns for those living with TB. Patients with respiratory impairment and/or lung damage may be more vulnerable to serious complications from COVID-19. Further, the global response to the COVID-19 pandemic is having unintended yet drastic consequences on tuberculosis (TB) services, with lockdowns and limitations on diagnosis, treatment and prevention services expected to increase the annual number of TB cases and deaths over the next five years; at least five years of progress on TB response will be lost.
There is a clear need for community engagement and innovation to solve for the continuity of DR-TB services during the pandemic and after, since health systems would take time to return to efficiency. To ensure continuity of DR-TB care for patients in high-burden countries amidst the lockdown, Johnson & Johnson decided to launch a hackathon-style initiative in May 2020 – the DR-TB Lifeline QuickFire Challenge (QFC). The challenge aimed to identify and support innovative community-based solutions to help patients connect remotely with healthcare providers and access digital and peer-to-peer support from the comfort of their own home.
LSW: Is this a global initiative?
Vandita Gupta: The Johnson & Johnson DR-TB Lifeline Quickfire Challenge is a global initiative aimed at supporting continuity of care for people living with DR-TB in high-burden countries. We were delighted to have received more than 111 unique ideas from innovators and organizations from all over the world, including 21 from India and 18 from the African continent. Two of the five awardees – who received both $50,000 in grant funding and mentorship from J&J experts – are Indian NGOs renowned for their work in TB Care and Management – Doctors For You and ZMQ Global. The other three projects are focused on Kenya, Philippines and Ukraine.
LSW: J&J’s Global Public Health itself has its expertise to provide health care support. What is the objective to seek partners?
Vandita Gupta: For nearly 20 years, both in our laboratories and on the ground in countries impacted by TB and MDR-TB, Johnson & Johnson has been supporting global efforts to end TB, including by discovering and delivering one of the most important new TB medicines in half a century.
But our experience in introducing a new TB medicine shows that medicines alone are not enough to tackle TB. We must strengthen our public health systems, train more health workers on the appropriate management of TB and DR-TB, raise community awareness, and ensure patients are diagnosed in a timely way and then successfully treated. We can’t do this alone. We need various stakeholders to come together to find solutions to combat TB at all levels.
This is why we are proud to collaborate with national and local governments, NGOs, and other partners to comprehensively address the challenges presented by TB and DR-TB.
In October 2019, we announced the expansion of our TB program in India, with a focus on helping the country scale up and accelerate its DR-TB efforts through new partnerships with the government and non-governmental organizations. For example:
• We are supporting a new effort with The Foundation for Innovative New Diagnostics (FIND), in collaboration with RNTCP, to build capacity and establish new TB culture and drug-susceptibility testing facilities in at least seven sites across India.
• We are also undertaking a unique collaboration with the International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia office, to support efforts aimed at building capacity of public-sector healthcare providers in seven states to effectively manage TB and DR-TB, in line with India’s new treatment guidelines.
• To raise awareness about TB, we are collaborating with the MTV Staying Alive Foundation to support a first-of-its-kind youth-focused, edutainment media campaign.
LSW: Few words on the strategy adopted by the two recipients of J&J grant-Doctors for You and ZMQ global.
Vandita Gupta: Doctors For You (DFY) has designed a sustainable potential solution that uses telemedicine via WhatsApp and Uber-style Nikshay Kavach delivery services to continue providing critical DR-TB care services to patients remotely, in line with the National Tuberculosis Elimination Program goals.NikshayKavach delivery staff help patients gain access to medicines and testing facilities.
ZMQ Global (India) has developed a Patient’s Active Compliance and Treatment toolkit (PACT). They use Video Observed Therapy (VOT) to empower patients with adherence reporting, connect them with remote health consultations and emergency care, and leverage behaviour change tools to promote treatment adherence.
We are proud to support Doctors For You and ZMQ Global, among other organizations, as they continue to work tirelessly on the ground to help TB patients receive the care and support they need during these challenging times.
LSW: How is the response so far on the activities and what is your forecast for the future?
We are delighted with the overwhelming response to the DR-TB Lifeline Challenge. As mentioned, we received111 ideas from innovators and organizations from all over the world, including 21 from India and 18 from the African continent. We are thrilled to have been able to support five organizations around the world who are working to help ensure that people with TB can be safely treated at home, where possible, during this challenging time. Despite the pandemic, we remain as committed as ever to our goal of driving progress toward a world without TB – and we are continuing our efforts to support programs across the spectrum of TB care.
LSW: The current project is focusing on Tuberculosis. Will J&J be looking at other areas too?
Vandita: Johnson & Johnson Innovation – JLABS has developed the QuickFire Challenge platform with the aim to empower and enable potential ground-breaking science and healthcare solutions by encouraging students, entrepreneurs, researchers and start-up companies to tackle some of the world's most challenging problems in healthcare. With this goal in mind, the Company has launched a series of QuickFire Challenges.
Read on to know how J & J's grant recipients contributed their bit to make it a success
Doctors for You (DFY), founded in 2007 is a not for profit organisation with a vision ‘Health for All’ is known for its disaster relief and response work. During this ongoing COVID 19, it has set up 12 Covid centres in six states, and also extended its support to over 20 hospitals in Mumbai by providing PPE kits and other necessary things.
Doctors for you, has been associated with J&J in their healthcare programs related to tuberculosis since 2015. Now, being a recipient of J &J’s Quickfire program grant, DFY has already started implementing J&J’s program related to tuberculosis patients particularly, those that are drug-resistant, partly in Mumbai and Pali district of Bihar.
Click here for |
According to Dr. Ravikant Singh, Founder, Doctors For You, “we got the grant under the quickfire challenge of J & J. We started the project in July. The grant is for a period of six months to do the pilot, and based on the learning from this project; we will expand it to other districts.
Dr. Ravikant Singh, MBBS, MD - SETH GSMC & KEM HOSPITAL MUMBAI
Click here to view profile
Other than this pilot project, we are also working with J & J on strengthening district-level drug-resistant tuberculosis treatment services as well as we are training government and private doctors on management. We have chosen one rural and one urban region for carrying out this project.
The project is going on well, and the district administration is very supportive. They have shared details of the drug-assistant TB patients. We visit the households; we have also set up a helpline number. If they call us, we solve their problem”.
LSW had an exclusive telephonic interview with Dr. Ravikant Singh, Founder-Doctors for You. Here are some of the activities shared by him:
How severe will COVID-19 prove to a TB patient?
A TB patient's lung is already immunocompromised. Therefore, if a TB patient contracts COVID-19, then he/she can develop serious complications. There were one or two cases in Mumbai. A couple of TB drug-resistant patients contracted COVID-19. Fortunately, they recovered. But the results may not be the same for all those suffering from the diseases because COVID-19 affects people in different ways. We have set up a separate ward for TB patients affected by COVID-19.
Will you expand your services in the future?
Yes, we will definitely. If we get good feedback, we will expand.
What is the recovery time?
Generally, 9 months to one and a half years or two years. It depends on the type of TB and the organs that are affected. People of all age groups can contract tuberculosis.
What is the overall success rate?
The treatment success rate is more than 90/95 per cent. If the patient follows all the guidelines and takes the treatment as prescribed, then there is no problem. The outcome is good, which is why we have come up with this project.
How will post COVID-19 pandemic life look like?
We will have to continue with the "new normal" and masks are going to be a part of our lives for the next one year-and-a-half to two years. Moreover, we do not have substantial vaccines for everyone. Also, we aren't aware of the long-term side effects of the vaccine on our health. Talking about the short-terms gains, the vaccine may be safe for about six to eight months, but the real side effects may show only after eight to ten years.
The more worrying thing is that on an average we as human beings, we have destroyed our nature horribly. Every year there is a spill over of animal-to-human transmission of a new virus. The most recent one being a disease caused because of rats called the Chapare virus. This is more fatal than corona virus. The ecological balance of this planet is severely disturbed and hence the outbreak of such diseases. We are paying a heavy price for destroying nature.
What causes TB?
TB is called because of bacteria called Mycobacterium tuberculosis. And TB patients who are drug-resistant need isolation. Hence, J & J has launched a new drug called Bedaquiline. TB continues to be a killer disease, but it has a cure.
We began as a group of 5-10 people, but now we have 1000 staff all over India, and we also have a hospital in Bihar which was constructed last year.
We have constructed a 50-bed covid hospital in Bihar. We can manage mild asymptomatic cases to severe cases we also have ICU. The hospital is run on solar energy, so it is cost-effective.
On Future Plan?
For TB projects we are planning to expand this program in other urban setting with high population density and TB cases as well as in rural areas with high TB incidence.
ZMQ Global – Technological approach to healthcare
Twin brothers Subhi and Hilmi Quraishi who were in Moscow for their Ph.D studies were forced to come back due to their father’s demise. As per their father’s wish, they thought of doing something for the society. It was then they established ZMQ Global (India), a non-profit technology-based development company to design solutions.
Quraishi Brothers - Hilmi and Subhi Quraishi
After looking into various areas like education, health etc, and they chose healthcare. They started with a mobile phone game to create awareness about HIV AIDS through Reliance Our World Network reaching over 27 million people across India.
Thereafter, the company focused on Tuberculosis by introducing Active Compliance Treatment Strategy (ACTS). For details visit: http://www.freedomtb.org/
Awareness about Tuberculosis is created in the villages through story-telling, digital games and tools.
Click here for |
Identifying villages that are more prone to Tuberculosis, the company recruits volunteers to do house to house screening of people with a mobile device and collect the sputum.
“Thus once the patient is identified, we put him/her on treatment. Then we give him/her a tool. In most cases, it is a mobile tool. However, if the patient does not have a mobile phone, then provide him/her with a phone so that he/she remains connected with the health system during the course of the treatment. He/she keeps the system keep track of his/her adherence. The patient need not go to the health provider but can remotely take his medicines and keep the provider updates” quoted Subhi Quaraishi, one of the twins, who heads the technical program of the organisation.
To know more about the activities of ZMQ Global, LSW had a telephonic chat with Shubi Quraishi. Here are the excerpts:
LSW: On J&J’s association:
“J&J called us for their Quickfire Challenge program for Drug-resistant TB patients. We thought of doing some innovations. We decided to give tools to drug-resistant TB patients to update their health to the provider remotely and thus extended our initiative to the Drug-Resistant TB through J & J. It has boosted our activities and opened a new sector for us. It has helped us in extending our programme. Remote consultation n tool that helps a patient in getting in touch with the health expert.
We have been promoting technology even before the pandemic. And the pandemic has emphasised on the importance of digital connectivity. It is not a mere enablement tool, but it has become a lifeline for people. We also launched Freedom COVID-19, where we ensured that people on the streets, walking back to their homes get free of cost digital connectivity. We have treated over 12000 patients and with J & J, 150
We cover one full district of Mewat, which has about 480 villages, and the whole model is under review by the National TB programme. The idea is not only about providing videos tools but also keeping patients motivated to continue the treatment. It takes longer to get the treatment done, and hence it is important to keep them inspired and motivated from start to finish.
Click here for |
LSW: On your achievement front:
We have been promoting technology even before the pandemic. Now, it has emphasised on the importance of digital connectivity. It is not a mere enablement tool, but it has become a lifeline for people.
We also launched Freedom COVID-19, where we ensured that people on the streets, walking back to their homes get free of cost digital connectivity. We have treated over 12000 patients and with J & J and150 DRTB patients. We have even exported our programme to the government of Uganda. And we are glad that we have found acceptance from our National TB programme.
LSW: Objective of ZMQ Global
We want the government to implement our programme because it is for the larger cause at a national level. Our main objective is to build sustainable models and tools that will come in handy in the long run for many beneficiaries. We will be willing to join hands with corporate, but we are essentially a non-profit organisation.