2015

Transforming TB Detection Through Bio Detection Innovation

Services

Health Service Design, Program Design, Ecosystem Mapping, Stakeholder Engagement, Process Optimization, Monitoring & Evaluation Support

Team

Innovation Expert (USAID), Public Health Specialists, APOPO Scientific Team, Local Clinic Stakeholders, Monitoring & Evaluation Unit

Event Wrap Up
Event Wrap Up

Reimagining Tuberculosis Detection Through Low-Cost Biological Innovation

Global Health Innovation

Early Disease Detection

Low-Resource Environments

Scalable Diagnostics

Human & Animal Collaboration

Overview

Tuberculosis remains one of the world’s deadliest infectious diseases, especially in low-resource settings where diagnostic capacity is limited. USAID partnered with APOPO to accelerate early TB detection using an unexpected but highly effective, HeroRATs, African pouched rats trained to detect TB-positive sputum samples through scent. As the Innovation Expert on the USAID side, I supported the initiative by mapping the operational ecosystem, identifying workflow gaps between laboratories, clinics, and APOPO facilities, and helping design scalable service processes that could be adopted by public health partners. The goal was to create a reliable, repeatable, and community-centered diagnostic service model capable of identifying more TB cases faster and at a fraction of traditional costs.

Understanding the Detection Bottleneck

Why Thousands of TB Cases Were Going Undetected

Microscopy, the primary diagnostic tool in many clinics, misses a significant number of TB-positive cases, especially when patients have low bacterial loads. Clinics in Tanzania and Mozambique faced overwhelmed labs, limited staff, and slow turnaround times, leading to delayed treatment and continued community spread. My role involved analyzing the end-to-end diagnostic journey, identifying where cases were lost, and designing a service blueprint that integrated HeroRAT screening into existing health systems with minimal disruption while maximizing detection yield.

Field Visit with USAID Tanzania Team
Field Visit with USAID Tanzania Team

Designing for Scale

From Pilots to a Repeatable Cross-Clinic Model

To scale the program, we needed more than rats; we needed a service system. I facilitated co-creation sessions with APOPO trainers, clinicians, and USAID’s health and M&E teams to define the standardized sample transfer flows, better understand the quality assurance protocols, and try to make sense of the unified reporting mechanism for clinics, aiming to create a predictable daily screening rhythm utilizing HeroRAT capacity. These design interventions strengthened the reliability of rat-based TB detection and gave clinics confidence in adopting the innovation.

Apopo Hero Rats
Apopo Hero Rats

Building Trust in an Unconventional Solution

Human-Centered Design for Behavior Change

Introducing an unconventional diagnostic tool required sensitivity and strong communication. Many clinicians were skeptical about using rats for medical screening. I worked with USAID communications and APOPO’s outreach team to develop evidence-based narratives, visual explanations, and field demonstrations that emphasized scientific rigor, accuracy rates, and speed. This human-centered approach helped shift perceptions, increasing adoption and fostering collaboration across clinics.

Key Insights
Key Insights

Impact

A Faster, More Accurate TB Detection Pipeline

The redesigned diagnostic workflow enabled HeroRATs to screen hundreds of samples per day, reducing detection time from days to minutes. Clinics using the service reported up to 45% more TB-positive cases identified than through microscopy alone, ensuring that previously undiagnosed patients received timely treatment. This service design effort strengthened USAID’s ability to scale the innovation across partner clinics and contributed to a more resilient TB-detection ecosystem.

+45%

Increase in TB case detection

Clinics identified significantly more positive cases compared to microscopy alone.

20min

Rapid screening capability

One HeroRAT could evaluate what took labs days to process. 100+ Samples in 20 minutes.

3X

Faster Workflow

Optimized sample journey. Streamlined transport and reporting cut diagnostic delays dramatically.

95%

Cost-effective model

Low-resource scalability. A sustainable approach usable in clinics with limited diagnostic capacity.

Evaluation and Results
Evaluation and Results

// These images bring the project to life, showing the partnerships, challenges, and quiet everyday moments that made this unconventional innovation possible. //

Reflection

Working on this project was one of the most meaningful chapters in my career. Being on the USAID side allowed me to collaborate with people from Tanzania, Mozambique, Belgium, and the United States, each with different perspectives, realities, and hopes for what better healthcare could look like. Bringing all these voices together wasn’t always easy, but it taught me what true co-creation feels like in environments where every decision can change someone’s life. Introducing the idea of using rats for medical diagnostics was, honestly, a challenge. It was unconventional, unfamiliar, and at times difficult for stakeholders to imagine. I spent months pitching an idea that sounded “too different” and sometimes even “too strange” to be taken seriously. But once we shifted our communication strategy, listened deeply to each audience, and shaped the story around their concerns, the doors that once felt closed began to open. That experience taught me that innovations don’t fail because they lack value; they fail because the story around them doesn’t meet people where they are. Receiving a U.S. Government Award for this work was an honour, but the real reward was witnessing communities trust this solution and seeing patients get diagnosed sooner because of it. This project reminded me why I chose service design: to connect unlikely ideas, unlikely partners, and unlikely solutions and help them become real, human, and impactful.

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