At a glance
CDC and partners are providing comprehensive training to ensure accurate and timely data drives innovation as India takes steps to eliminate TB. Addressing TB at its source is crucial for safeguarding national security.
TB challenges in India
In a significant public health achievement, India is taking bold steps to eliminate TB, the world's deadliest infectious disease. In 2023, India alone accounted for over 26% of global TB cases and deaths. It is widely recognized that global and U.S. TB elimination efforts will only be successful if India's TB efforts are successful.
Under the guidance of India's Central Tuberculosis Division (CTD), CDC and partners launched the Expand ELEVATE (E2) Project – an initiative to equip local and state health departments with the tools and ability to quickly analyze real-time data to make informed program decisions, leading to earlier TB diagnosis and successful treatment.
A Joint Monitoring Mission in 2019 found that the national TB program of India collected huge amounts of data, but data use was sub-optimal at the facility, district, state and national levels. Healthcare workers faced challenges with usage of the latest technology and inadequate training in data management practices.
As a result, vital information about patient care fell through the cracks – compromising diagnosis and treatment completion rates and overall TB program effectiveness. These shortcomings hinder effective TB service delivery, program performance, and decision-making at the local level.
Innovative interventions drive change
In response to these challenges, CTD, CDC, and partners launched the E2 Project serving 625 million people. The initiative focuses on comprehensive training among state and district-level healthcare staff to make timely TB program decisions based on reliable data.
Key interventions as of March 2025 include:
- Capacity Building: Over 3,150 state and district staff trained on data analysis techniques to help analyze local TB data quickly and effectively.
- Data Champions: Over 444 staff members identified as 'data champions' to receive further mentorship and guidance.
- Field Support: CDC and partners have conducted over 100 field visits across various districts to identify program gaps and develop actionable plans.
This type of cascading training model allows staff to mentor others, creating a ripple effect that amplifies knowledge and skills throughout the health system as well as across regions.
Success within and beyond TB
Faster data collection and analysis at the local level is crucial for prompt decisions and actions to improve early diagnosis and treatment success and, ultimately, prevent the spread of TB. When combined with program delivery, the E2 Project showed measurable improvements:
- Faster Diagnosis: The average time from TB detection to starting treatment was reduced by 40-60 percent.
- Enhanced Data Analysis: Staff can now conduct analyses within a few hours, which previously took days, and over half the staff can analyze data independently.
- Improved Indicators: Out of 262 key performance indicators, over half (133) showed improvement compared to the previous quarter.
This approach strengthens overall health system performance without additional resources by promoting collaboration among multiple disease control programs.
"The ability to analyze our local situation has transformed how we approach our work – it's no longer just about reporting; it's about making informed decisions that save lives."
- Program Data Analyst
Global implications
Addressing TB at its source is crucial for safeguarding national security. The threat posed by drug-resistant strains of TB further emphasizes this urgency; without effective intervention, these strains can easily cross borders and lead to outbreaks that threaten communities around the world, including in the U.S.
Through the E2 Project success, CDC helps reduce TB and drug-resistant TB in the country that contributes most to the global burden and is a leading contributor of TB cases in the U.S., ultimately ensuring a safer and stronger future for Americans.
"Enabling 'data champions' and aiding in developing resilient public health infrastructure through innovations is a significant step toward ending TB in India and worldwide."
- CDC India's Tuberculosis Chief
By prioritizing data-driven decision-making and empowering local champions within the healthcare system, CDC is paving the way for a healthier future where no one falls through the cracks. Together, governments can build stronger health systems responsive to community needs and resilient against future threats.