What are DATs?

Click here to learn more about Digital Adherence Technology (DAT) to support TB treatment adherence.

Why are DATs important?

DATs have been proven to make adherence to TB treatment more convenient. Click here to learn more.

Drivers of success

Click here to learn what drove ASCENT project to end successfully after 5 years of planning, implementation, and evaluation.

Country experiences

Country experiences varied in context and engagement. Click here to learn more.


A collection of perspectives from participants, healthcare workers and officers can be found here.

Market Landscape

Scaling-up DATs and digital platforms opened a window of opportunities in the market, supply chain, and reality of TB treatment delivery and adherence. Click here to know more.

Future opportunities

Check out the future opportunities for DAT in TB care that ASCENT project brought along.

Spread the word

Success stories are meant to be told, and ASCENT is no exception. Share this page with your networks and spread the word.

ASCENT: A project that involved more than 19,000 people living with tuberculosis across five different countries.


Digital Adherence Technologies (DATs) are tools generated to provide daily support for individuals in the continuation of their treatments through the use of mobile phone, computer, web-based and/or electronic sensor technology.

Check out below the three DATs used throughout the lifecycle of ASCENT project:

Medication Label

custom packaging to support treatment adherence.

Smart Pill Box

battery-powered and mobile data connected box for medication storage and dispensing.

Video Supported Treatment

remotely observed treatment via mobile video application.

“The smart pill box seems to be the most successful DAT within our project”

Kristian van Kalmthout, ASCENT Project Director


Tuberculosis takes 1.5 MILLION lives around the world each year.

DATs can help to support people affected by TB with their treatment in a modern and effective way.

Direct Observation Treatment (DOT) entails:

  • Recurring visits to health facilities.
  • Out-of-pocket costs for people living with TB.
  • Time off from work and away from family.
  • Specialized TB care facilities.
  • Increased workload for trained TB care providers.

Successful TB treatment requires strict adherence schemes, usually in the form of directly observed treatment (DOT).

This makes DOT inconvenient for

people living with TB

Travel to TB health facility. The Philippines

“With DOT program, all patients (pregnant, disabled, seriously ill), all must visit treatment center every day to take their medication.”

Hana (Health Officer), Ethiopia

“This saves me time and transportation money. I also get less exposure to COVID-19”

Ronaldo Geronimo (43), the Philippines

With DATs:

Daily medication can be taken at a suitable time and place.

Health care providers can remotely follow treatment progress.

Treatment support is tailored to individual needs.


“The digital adherence technology of ASCENT, particularly the smart pill box, does not only help our patients. It also helps our healthcare workers in distance monitoring using the ASCENT adherence platform.”

Mohammad Maximo (Rural Health Physician), the Philippines







ASCENT proved the transferability of DATs to different settings with diverse populations in support of the TB treatment cascade.

In collaboration with the National Tuberculosis Programs (NTPs), DATs have supported people in regaining ownership of their TB treatment and livelihoods across the study countries.
In Ukraine, the digital platform showing a person taking their medications uninterruptedly meant more than just the TB treatment adherence, it was also a sign that the person was still alive during the conflict.
TB care provider using the adherence platform. Ukraine

“…it has helped us get timely data.”

Irene Noah (DOT Provider), Tanzania

172,200 NEW and RELAPSED TB cases notified each year.

ASCENT project was executed with the support of the National Tuberculosis Program of the Department of Health of South Africa. Our project enrolled 3,084 participants and trained 157 providers in 64 healthcare facilities in the Gauteng Province (Tshwane District) and Western Cape Province (West Coast District).


104,600 NEW and RELAPSED TB cases notified each year.

ASCENT project was executed with the support of the TB, Leprosy, and Other Lung Disease Desk of the Ministry of Health of Ethiopia. Our project enrolled 4,342 participants and trained 155 providers in over 80 healthcare facilities in Addis Ababa and Oromia.

The Ethiopian instance of Everwell Hub continues to be hosted at the KNCV- Ethiopia data center. The goal is to transfer the system to the Ministry of Health.
Currently, seeking funding for the continuation of DAT in enrolled health facilities and potential scale-up.

18,300 NEW and RELAPSED TB cases notified each year.

ASCENT project was executed with the support of the National TB Programme, Public Health Centre and the Ministry of Health of Ukraine. Our project enrolled 1,645 participants and trained 223 providers in 24 rayons (districts) in five oblasts (provinces).


86,700 NEW and RELAPSED TB cases notified each year.

ASCENT project was executed with the support of the National Tuberculosis and Leprosy Programme and the Ministry of Health, Community Development, Gender, Elderly and Children of Tanzania. Our project enrolled 4,776 participants and trained 72 providers in 72 healthcare facilities in Arusha, Geita, Manyara and Mwanza.

As a solution for low-cost continuation of the adherence platform, the smart pill box Application Programming Interface (API) is planned to be integrated into the DHIS2 system. This adherence platform is being adapted to support TB treatment as well as TB Preventive Treatment (TPT) adherence.
Currently in development of a DHIS2 (District Health Information System) generic app for potential use by any country with DHIS2 instance.

321,600 NEW and RELAPSED TB cases notified each year.

ASCENT project was executed with the support of the National Tuberculosis Control Program and the Department of Health of the Republic of the Philippines. Our project enrolled 5,470 participants and trained 157 providers in 64 healthcare facilities in Bulacan and Papanga provinces.

The Department of Health of Philippines in partnership with the Philippines Business for Social Progress (PBSP) have already procured 6,000 Smart Pillboxes for use in the Philippines, with special emphasis on DR-TB treatment.
DATs have been integrated in the Philippines application for the Global Fund Grant Cycle 7 through PBSP. PBSP as Global Fund grant recipient in the Philippines, took over the management and funding for the Everwell Hub.
Currently, the Philippines is in the initial testing phase for integrating the Smart Pill box Application Programming Interface (API) into the in-country data system.

The smart pill box median engagement ranged from 94% to 100% across countries! This means: most of the people supported by a smart pill box actually used it!


ASCENT has built on the evidence to inform guidelines on DAT use for supporting TB treatment adherence. From a wider perspective, including DATs in TB treatment journey means much more.

Scroll through the perspectives of participants, health officers and healthcare workers involved in the project:


Strong partnerships established through advocacy, collaboration, and listening to the inputs of partners (for example, local patient groups) are key to the early buy-in, ownership, adoption, and scale-up of DAT.

COVID-19 pandemic marked a before and after in the Digital Health realm.

DATs that support people remotely during times of physical distancing, challenged mobilization and country-wide lockdowns, broadened the perspectives and the uses of digital tools that Departments of Health can benefit from in order to reduce TB burden in communities.

By 2023:

  • We have achieved the integration of digital tools to support healthcare access and delivery, not merely as a luxury but as a solution to a growing demand.


  • A series of valuable resources have resulted from the implementation of such a big project as ASCENT. Besides providing sound scientific evidence on the effectiveness and impact of the use of DAT in TB treatment, it was possible to develop a Total Cost of Ownership tool as well as other financial/budgeting guidance and planification resources. (Learn more here)


  • The manufacturing of some DAT products has been transferred to local markets within study countries, an added value for sustainability and economic impact.


  • The cost of implementing DATs in the TB care cascade can be significantly lowered with the procurement of reusable DATs such as the Smart Pill Box, with proven reuse rate ranging from 1.6 to 3.5 depending on the context.


  • ASCENT has provided customized inserts for the smart pill box with the purpose of organizing the BPaL/BPaLM (Bedaquiline, Pretomanid, and Linezolid/+Moxifloxacin) oral regimen for DR-TB.
Countries other than ASCENT study countries standing at the forefront of Digital Adherence Technologies are: Uganda, Eswatini, Kenya, Nigeria, Somalia, Republic of Moldova, Georgia, Armenia, Azerbaijan, Kyrgyzstan, Belarus, Kazakhstan, Tajikistan, Turkmenistan, and Uzbekistan.
Click here if you want to learn more about the market landscape of DATs.


Evidencing that DOT providers continue to use DATs after the completion of ASCENT project resonates with the need for digital tools to support TB treatment adherence across different contexts.

On the basis of our lessons learned throughout these past five years, we identified that:

As the world is turning to be more digitally literate, DATs have a role to play in future treatment regimens.

There is an opportunity to evaluate different adherence approaches through digital tools, especially via mobile phones as mobile phone coverage ownership was found to be high across study countries (62%-89%).

There is room for the optimization of DATs supporting TB care, emphasizing person-centered approaches that are convenient for users, providers, and the health system.

There is a need for interventions aimed at reinforcing the role of people in their own treatment journeys.

Over the course of ASCENT project, rethinking optimal care for TB took different avenues as new challenges and opportunities arose: high rates of people with Rifampicin Resistant/Multidrug Resistant TB (RR/MDR-TB) both treated and untreated; and the development of shorter regimens for RR/MDR-TB (BPaL/BPaLM).


Through this page we aimed at uncovering the results of ASCENT project and the impact that Digital Adherence Technology has in supporting TB treatment adherence!

This page is not just a destination but a virtual knowledge platform for TB specialists, Digital Health enthusiasts, governments, and organizations in the pursuit of person-centered approaches to end TB.

Join us in revolutionizing the way we approach TB care!