USAID’s Alliance for Combating TB in Bangladesh (ACTB)

The USAID-funded Alliance for Combating TB in Bangladesh (ACTB), implemented by Social Marketing Company (SMC) from February 2021 to January 2025, marked a transformative chapter in the country's fight against tuberculosis. Operating across 32 districts in six divisions, the project aimed to bridge the diagnostic and treatment gaps by integrating informal healthcare providers into the national TB response. Through a "Search, Treat, and Prevent" model, SMC mobilized its extensive Star Network-comprising Blue Star Providers (BSPs), Green Star Providers (GSPs), and Gold Star Members (GSMs)-to reach underserved communities with TB screening, referral, and treatment support.

Over the four-year implementation period, SMC trained 6,415 Star Network providers and screened 165,975 individuals for TB symptoms. Of these, 147,624 (89%) were referred for diagnostic testing, resulting in 16,161 confirmed TB cases. These included 10,967 bacteriologically confirmed cases, 2,861 clinically diagnosed cases, and 2,333 extra-pulmonary TB cases. Notably, 501 child TB cases and 48 multidrug-resistant TB (MDR-TB) cases were identified and enrolled in treatment. These outcomes reflect the project's success in expanding access to TB services, particularly in hard-to-reach and high-burden areas.

SMC's innovative use of digital tools played a critical role in enhancing program efficiency and accountability. The "ACTB Solution" mobile app enabled real-time reporting and supervision of field activities, while the "Tele-Jiggasha" platform provided remote counseling, treatment adherence monitoring, and contact tracing. These tools ensured that patients remained engaged in care and that providers received timely technical support. The project also implemented a robust data quality assurance system, which led to improved alignment between field-reported data and national TB records.
Community engagement was central to ACTB's success. SMC conducted 264 miking campaigns, 344 community awareness meetings, and 116 district-level advocacy sessions to raise awareness and reduce stigma around TB. GSMs-trained rural women entrepreneurs-played a vital role in door-to-door outreach, identifying presumptive cases and linking them to diagnostic services. Institutional campaigns in schools, madrasahs, and workplaces further extended the project's reach. These efforts fostered local ownership and encouraged early care-seeking behavior.

Despite its achievements, the project faced significant challenges. The COVID-19 pandemic disrupted early implementation, delaying training and reducing screening rates. Budget constraints, policy shifts, and the premature closure of USAID funding in January 2025 further impacted field operations. Nonetheless, SMC adapted through strategic planning, internal resource mobilization, and strengthened coordination with the National TB Program (NTP) and partners like BRAC, icddr,b, and Damien Foundation.

As the project concludes, SMC has developed a sustainability and transition plan to preserve its gains. Key strategies include integrating TB services into existing health platforms to focus on child TB, and aligning with national health priorities. SMC also plans to institutionalize its monitoring and evaluation systems and explore diversified funding sources to maintain momentum in TB control.

The ACTB Activity leaves behind a strong legacy of innovation, collaboration, and community-driven impact. It demonstrated the power of public-private partnerships in addressing complex health challenges and laid the groundwork for a more resilient and inclusive TB response in Bangladesh. As SMC and its partners move forward, the lessons and systems built under ACTB will continue to inform national strategies and contribute to the global goal of ending TB by 2035.

SMC developed a mobile based monitoring mechanism "Tele-Jiggasha" (telecommunication platform) for counseling and following up of the presumptive and diagnosed TB cases. This platform is also used for counseling and treatment referral for Adverse Drug Reactions (ADRs).

SMC is committed to work with the NTP to achieve the End TB targets and goal in 2030 and 2035. Therefore, the company has aimed to expand and implement this ACF activity in all over the country in addition to USAID's ACTB Project implementing areas.