Poor adherence to medication is deeply tied to disease relapse and the potential development of drug resistance, yet adherence is an understudied link in the chain of infection. Medical adherence is an area in need of innovation, experimentation and scaled implementation of evidence-based programs. When I led USAID’s tiered, evidence-based innovation fund, Development Innovation Ventures, we decided to double-down on supporting the further testing at larger scale of the Keheala approach, giving the promising findings that emerged from its initial randomized controlled trial that we had previously supported and Keheala’s commitment to evidence, cost-effectiveness, and iteration on its model. From my current perch leading Evidence Action’s efforts to “incubate for scale” promising, evidence-based interventions, I’m looking forward to watching Keheala’s next phase of testing and iteration, as the company aims to strengthen its evidence base and a more scaleable operational model.
Keheala represents a breakthrough in improving patient adherence because it goes beyond a daily reminder: it bolsters the social support network for vulnerable patients, improving quality of life at the same time as it helps cure disease.
Keheala has the potential to revise what we consider acceptable success rates in tuberculosis treatment, and it epitomizes the ideal public health intervention, so rarely realized: improved health outcomes with reduced costs.