An innovative program that uses widely accessible text-message and Internet services is saving lives by bringing much-needed medical supplies to remote areas–and it has wider applications elsewhere.
The SMS for Life private-public partnership has addressed the critical issue of keeping malaria medications in stock for medical providers in Tanzania and sub-Saharan Africa. It began with a 6-month pilot in 2009 to 2010 of 129 health facilities serving 1.2 million people in three regions in rural Tanzania, where the malaria problem is acute. In Tanzania, 93% of the population is at risk of infection; there are 11 million cases of malaria per year and 60,000 to 80,000 deaths from the disease. Stock-outs of malaria drugs are a huge and persistent problem in Tanzania and in many other sub-Saharan African countries. Once drugs are shipped into the country, there is zero visibility on what happens with them.
The SMS for Life program, through collaboration between Novartis, Roll Back Malaria Partnership, Vodacom and Vodafone, IBM, and Tanzanian Ministry of Health and Social Welfare, used mobile telephones, SMS messages and electronic mapping technology to facilitate comprehensive and accurate stock counts from all health facilities to each district management team on a weekly basis. The process was simple: Each week, staff at the health facilities received a text message requesting stock counts of the selected malaria drugs; when they responded, they earned free air time on their mobile phones. The data enabled partners to ship supplies quickly, track usage of the anti-malarial drugs by facility and region, and to see where outbreaks occurred.
The results were impressive: Stock-outs were reduced from 79% to less than 26% in the three districts. At the beginning of the pilot, 26% of the facilities had no dose form of the Novartis antimalarial ACT and by the end, this figure had been cut to less than 1%.
Prof. David Mwakyusa, former Minister for Health & Social Welfare of Tanzania, expressed his gratitude when presented with the SMS for Life pilot results in April 2010. “I’m grateful for what you are doing for my country – I lose a child every five minutes which is a waste from a disease that is completely preventable. This is a great project and an innovation that I support very much, it’s exciting to me.”
Such a public-private partnership can have wide-reaching, positive effects.
“This is an example of a truly innovative solution helping solve a humanitarian problem,” says Peter Ward of IBM, SMS for Life Project Manager. “After spending time on the ground, we created a project plan, developed the application with Vodafone and Novartis and established the best way to deliver the pilot, working with the Tanzanian Ministry of Health. We expect other countries will also be able to benefit in the future.”
Since then, SMS for Life has been rolled out across Tanzania, with more than 5,000 facilities trained and reporting on a weekly basis. Tracking of tuberculosis and leprosy medicines has also been added.
In Ghana, the partnership is conducting a pilot in six districts, sponsored by the Swiss Tropical and Public Health Institute. They are tracking weekly stock levels at public health facilities of ACTs (artemisinin-based combination therapies), Rapid diagnostic tests (RDTs) and antibiotics.
In Kenya, in addition to tracking stock levels of ACTs and RDTs, the partners are conducting a patient surveillance study on the testing of patients with malaria and the use of ACTs.
Moreover they are exploring expansion of SMS for Life into the Democratic Republic of the Congo.
Overall, the SMS for Life system was built to be a generic and highly scalable solution that can be leveraged to support any medicine or product, and can be implemented in any country with minimal tailoring. Additionally the system could also be utilized for disease surveillance.
It’s inspiring to see how everyday technology that we take for granted can have such a profound effect on human health.