Each year, World TB Day is celebrated on March 24th, intended to commemorate Dr. Robert Koch’s initial discovery of Mycobacterium tuberculosis, the bacillus that causes tuberculosis (TB). While the day focuses on public education surrounding the impact of tuberculosis, it is also meant to raise awareness of challenges that impede us from global elimination of TB.

For decades, state and local health departments’ efforts have been the primary reason for successful TB management in the U.S. While they are critical in protecting Americans from a disease that kills 1.5 million people around the world, public health remains chronically under-funded: leaving the dedicated, hardworking heroes of public health to try and do more with less.

With a strong, foundational footprint in public health, emocha recognizes the need for sustained investments in public health infrastructure. The COVID-19 pandemic has served to highlight the need for additional resources. State and local health departments have faced numerous challenges, and are working around the clock to protect the public. As health departments are tasked with infection investigation, contact tracing, advising leaders on next steps, and disseminating information to the public on best practices for combating an outbreak, they represent the country’s front lines of defense. 

Earlier this month, Congress passed an $8.3 billion emergency spending bill intended to help state and local agencies combat coronavirus. A large chunk of the money helps pay for local response activities ranging from infection control to lab testing, but during a national disaster, it can take months — sometimes up to years — for federal reimbursement to reach states and finally counties. During this pandemic, as we realize the importance of sustained public health infrastructure, there are innovative ways to further achieve risk reduction and resource allocation among public health agencies.

TB is one of the top 10 causes of death worldwide and the leading infectious cause of death, with a total of 1.5 million people dead from the disease in 2018 alone. Yet TB is both treatable and curable, with a standard 6-month course of antimicrobial drugs: a regimen that demands rigorous treatment adherence. Ensuring medication adherence to facilitate optimal outcomes requires continuous support and patient-centered interventions. While Directly Observed Therapy (DOT), the practice of watching a patient take every dose of medication, is endorsed by the U.S. Centers for Disease Control and Prevention as the gold standard of care for TB treatment, the protocol requires patients to receive medication via daily visits to health departments or clinics. 

A proven and validated public health strategy, video Directly Observed Therapy can be leveraged for both COVID-19 exposures and tuberculosis. The symptoms monitoring capability of video DOT reduces exposures of healthcare workers, prevents exposing patients with TB to COVID-19, and expands the capacity of health departments as resources move towards COVID-19. This method can not only help secure adherence for those patients with infectious diseases, but also meet the intended needs of Directly Observed Therapy: including the engagement and relationship formed between both patient and provider.

As public health departments are increasingly faced with the enormous challenge of confronting COVID-19 in addition to tuberculosis, sustained support and infrastructure are critical. Through technological innovation, we can provide crucial help to public health agencies as they mount responses to a global crisis.