Over 1.25 million people died from Tuberculosis (TB) in 2023, with around 10.8 million people falling ill from this disease, including 6 million men, 3.6 million women and 1.3 million children, according to the WHO (World Health Organisation) data. TB has once again become the leading cause of death globally and is also the leading killer among people with HIV. Paediatric TB accounts for 6% of all TB cases. In an effort to curb paediatric TB (tuberculosis), John Hopkins University, in collaboration with Indian institutions and the Indian government, has launched the TB-free school initiative across three states, with an aim to curb paediatric TB, through prevention, treatment and education.

Women form 43% of STEMM (science, technology, engineering, mathematics and medicine) graduates in India, whereas they comprise only 17% of its research workforce, highlighting the need for such programmes. This aligns with the global trend, where women make up just 29% of the STEMM workforce, according to the WEF (World Economic Forum). To address women’s underrepresentation in STEMM fields, the Gupta-Klinsky India Institute (GKII) has rolled out a career advancement programme.

Emphasising the importance of curbing TB right from the schools, Dr. Amita Gupta, director, division of infectious diseases, Johns Hopkins University School of Medicine, highlights the involvement of private sectors in research and development. She said, “Engagement of private sectors should be done. I’d like to see corporate social responsibility invest in research and development, not just service oriented programmes. Creating research centres of excellence, investing in people’s research career development like STEMM fellowship or TB free schools where we can have that engagement.”

On being asked about the cost-effectiveness of the TB-free school initiative, Gupta shared, “It’s aligned with TB-Mukt Bharat but we need the evidence, so right now the govt. of India doesn’t have a policy to do screening for TB in schools. TB free school initiative is an effort to get the necessary evidence through research to see the cost-effectiveness of screening children in schools.”

A qualitative assessment, data collection, and interviews of children will be done, in which their TB symptoms will be recognised, she notes.

“A skin test called Cy-TB will also be done that’s made very cheaply in India itself, in which you can place it on skin and can read it 48 hrs later and see if there’s a reaction, which usually means you’ve been exposed to TB and we have latent infection. Cy-TB test is made by the Serum Institute of India (SII),” explained Gupta.

Speaking about the inclusion of AI, Gupta mentioned a little portable camera that can be used in a classroom. With just a click, the child’s chest X-ray comes right on the computer screen. All of this can happen very fast. Within a few minutes the child can get screened by moving from station to station.

How cost-effective is this initiative?

We can prevent one case of lifetime TB with about $21 of investment. We want to test if this cost aligns with our estimates.

AI-powered platforms require large amounts of patient data, which can be incomplete or inaccurate. How do you fix this?

The quality and the amount of data matters and AI can be trained to read chest X-rays, so if you’re in a rural area, a radiologist might not be needed, AI can read it right there in a rural school.

There might be situations where AI can face problems with explainability which means it can lead to situations where the results are trusted but can’t be verified, which may result in wrong decisions. How do you make it better?

It’s possible for AI to produce erroneous results if it was not trained on high-quality data. Therefore, safeguards are still in need to ensure best use of this technology. Even when AI is perfected, there will still be a need for humans.

How has JHU leveraged local partnerships to address India’s health challenges?

Many of our team members are either from India or live in India full time or have been trained at Johns Hopkins and came back to India, it’s one way of doing it. Another way is we’ve had success with multiple brands whether hospitals, research centres and private sector collaborations, so we invest for the long haul.

With AI becoming integral to business education, which competencies and leadership skills do Carey’s programs prioritise to prepare graduates for an AI-driven global market?

You have to be curious and flexible, and be able to question. I put in a case history in AI to see its response, I was surprised to see its response was so authentic and laced with references, but since I am from a medical background, I knew that the response was completely wrong.

Speaking on the strategy for partnering with healthcare institutions in India, Alexander Triantis, dean of Johns Hopkins Carey Business School emphasises on the focus on business in health in Carey Business school with a focus. “We focus a lot on digital health and AI as one area, and we also focus on areas related to pharmaceuticals and how to properly design strategies and implement those.”

“Our MBA has many students who are doctors, nurses and health professionals like people who have PhDs, we help them round that education up with business acumen,” Triantis adds.

When asked about AI data inaccuracies, Triantis shared, “We do focus on data in health sectors and how to use it to get all sorts of insights about new innovations that can go to the market. With any data, a part of our research faculty knows how to spot through systematic ways when data is inaccurate. Bias in data, which means it might be accurate but not representative, for that we’re trying to understand how to design AI algorithms that are unbiased about how to take the results from AI algorithms to apply to different populations, that’s why we need the research the universities are doing on their own or in partnerships with industry as well.”

Paediatric TB

Combating Paediatric TB in schools and bridging the gender gap in STEMM fields