Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death worldwide, causing around 30 lakh (3 million) deaths in 2019. Nearly 90% of COPD deaths in those under 70 years of age occur in Low- and Middle-Income Countries (LMICs).

India has the highest Tuberculosis (TB) burden in the world. In 2021, India recorded around 20 lakh (2 million) TB cases and around 5 lakh (500 thousand) TB-related deaths. A majority of those who were symptomatic (64%), did not seek healthcare services. Their reasons ranged from ignoring the symptoms (68%), not recognizing the symptoms as TB (18%), and self-treatment (12%). 2% couldn’t afford to seek care.

A huge percentage of these cases also come from underdeveloped, remote areas without proper access to healthcare services. Some of the factors attributed to the delay in diagnosis of respiratory diseases are mainly due to a lack of awareness, and social inhibitions in reaching a doctor or a peripheral health worker. Screening for respiratory diseases is an unmet need as due to limited human expertise and lab facilities, it is not possible to do pulmonary function tests at primary care level centres.

Spirometry is considered the gold standard for confirming the diagnosis of COPD but it is quite expensive and requires a skilled technician for conducting a test. Therefore conducting a respiratory assessment in a primary health centre has been an unmet market need.

In order to address this issue, the Ministry of Electronics and Information Technology (MeitY) awarded a research project to Jawaharlal Nehru Technological University Hyderabad along with other institutes. Narayan Rao was one of the advisors for this project during the course of which he met many doctors and understood the severity of the problem.

This motivated the team to focus on making Software as a Medical Device (SaMD) which is completely unconstrained from equipment, skilled manpower, consumables etc. They realized that any technology/tool which can facilitate screening and identify whether the problem is attributed to airway or lung parenchyma/pleura will be a highly useful value proposition for the appropriate next intervention.

Swaasa helps in reducing the gap in ignoring symptoms, and inaccessibility for the much-needed population. It uses cough as a biomarker to identify any underlying respiratory problems such as TB, Asthma, Pneumonia, Interstitial lung disease, and lung cancer. It can detect these disorders even through a forced cough. Its self-serve model wherein users can do assessments on their smartphones further reduces the concern of a health worker in collecting a sample where the infection is more prevalent. It also provides an SMS-based option, in which customers will receive a web link by SMS. Customers need to just open the link in the browser and record his/her cough sound.

Swaasa is not an incremental innovation to any existing method for lung assessment like making portable and economical spirometers, digital stethoscopes etc. The core technology is based on audiometric analysis of cough (and/or lung) sounds using patented Machine Learning (ML) algorithm residing in the Swaasa.AI engine in the cloud.

It has the ability to identify unique patterns in cough, making its mechanism reliable and integrating the same in clinical flow, making it disruptive innovation. Swaasa dispenses the need for any hardware (spirometer) bringing the capex from about ₹1 lakh to zero. On the operational expenditure side, the drop is even more precipitous going from roughly ₹1,000 per assessment (direct cost only) to ~₹1 per assessment (at scale).

Salcit is committed to bringing the highest quality respiratory care to the underserved populations of the world – not just in India.  To date close to 300,000 assessments were done using Swaasa. It has improved the respiratory case detection rate at sub-centre level.

Currently, the solution is deployed via B2B and B2G partnerships.  Piramal Swasthya and Apollo hospitals are using Swaasa App for overall lung health assessment. The company has signed an MoU with Smart Africa, an alliance of 30 African countries that represent 70 crore (700+ million) people, to deploy the solution in Africa.