Bold goal: mobile messaging could reshape TB treatment, but the real impact depends on people, tech access, and practical hurdles. A new Africa CDC study tests SMS reminders to boost TB treatment adherence in Ethiopia and Liberia, two countries with high TB burden. Funded with a $100,000 World Bank grant, the project runs from November 17 to December 12, 2025, and is conducted in partnership with national Ministries of Health, the University of Liberia College of Health Sciences, Dire Dawa University, and the Dire Dawa Health Bureau, with technical coordination from Africa CDC’s Science and Innovation Directorate.
TB remains a critical global health challenge. In 2023, about 10.8 million people were infected worldwide, causing over 1.25 million deaths. Ethiopia and Liberia face especially high incidence rates—approximately 119 and 308 cases per 100,000 people, respectively. Even with improvements in diagnosis and treatment, medication adherence often falters, leading to treatment failure, relapse, and drug-resistant TB.
The study explores a practical digital approach: using SMS reminders to support patients through their TB therapy. It seeks to identify barriers to adopting mobile health tools, test adherence improvements, and assess downstream outcomes. The project is titled “Improving TB Treatment Adherence through Mobile-Phone Messaging: Identifying Barriers, Facilitators, and Adoption Pathways in Ethiopia and Liberia.”
Dr. Mosoka Fallah, Acting Director of Science and Innovation at Africa CDC, emphasizes the potential for digital health to enhance Africa’s TB care. By tapping into the ubiquity of mobile phones, the initiative aims to make treatment support more accessible, timely, and effective for vulnerable communities.
The study unfolds in two phases in each country. First, a quantitative baseline will measure current adherence levels among TB patients. Next, a pilot intervention will deliver SMS reminders to patients identified as having low adherence. A total of 844 TB patients will be enrolled (422 in each country), with about 200 participants receiving SMS reminders. Both quantitative and qualitative methods will yield insights to inform national TB strategies and guide continental policy on digital health integration.
Dr. Fallah notes that this work aligns with Africa CDC’s focus on implementation science that strengthens public health actions in member states. Beyond TB programs, the project aims to contribute to Africa’s broader digital health agenda and provide evidence to support policy decisions.
The study’s anticipated outcomes include evidence on the effectiveness of SMS-based adherence support in Africa, an understanding of barriers and enablers to digital adherence tools, and guidance for TB control policies and programs in Ethiopia, Liberia, and other member states.
This effort reflects Africa CDC’s commitment to evidence-based innovations that accelerate progress toward ending TB by 2035, in line with the WHO End TB Strategy and the African Union’s health priorities.
About Africa CDC
The Africa Centres for Disease Control and Prevention (Africa CDC) is a public health agency of the African Union. It operates autonomously to help member states strengthen health systems, improve disease surveillance, coordinate emergency responses, and advance disease control. Learn more at http://www.africacdc.org and connect with Africa CDC on LinkedIn, X (formerly Twitter), Facebook, and YouTube.
Media contacts: Margaret Edwin, Director of Communication and Public Information, EdwinM@africacdc.org
