Habiba Banu
A child living with someone who has TB has roughly a 1-in-15 chance of developing TB. Prevention is simple and effective, yet only about 4 of every 100 children who need preventive treatment receive it; the route to it is a facility visit that costs a family lost wages and a long clinic trip.
BIG IDEA
Home-based tuberculosis care
Watch the pitch
The mission
Protect children from tuberculosis.
How it works
Every adult TB diagnosis tells the health system which children are at risk and where they live. Field staff get the patient's details from the public TB clinic, call the family, and visit the home: 1 visit, 4 symptoms checked for every household member, and 12 weekly doses of preventive medicine prescribed on the spot via telemedicine for symptom-free under-5s, with follow-up to completion.
The dream
TB prevention reaches every at-risk child in Pakistan as a routine, government-run part of the health system; at national scale about 5,500 TB cases prevented and 450 lives saved each year. Doer and payer at scale: government.
Potential for impact at scale
Read against four questions, in the context of the organisation’s stage: is the impact good enough, is the problem big enough, is the model simple enough to deliver at scale, and is it cheap enough for whoever pays at scale.
Good enough · impact and evidence
80% preventive-medicine coverage where Spiro works, against a roughly 4% national baseline, with a modelled 70% reduction in TB cases among those covered.
Big enough · addressable market
A national problem with a mapped delivery route: every diagnosis in the public system points to the next household.
Simple enough · to deliver at big scale
A 1-visit, 4-symptom, 12-dose protocol run by field staff plus a doctor on the phone; now being handed to government-funded community health workers in Punjab.
Cheap enough · for payers at scale
$20 per person given preventive medicine; $550 per TB case prevented.
So far
- 5,800 people reached with preventive medicine, 2,900 of them under 5 (June 2026)
- Working with 22 hospitals across 7 districts of Sindh
- Expanding to all 30 Sindh districts by November 2026, plus a Punjab launch with government community health inspectors