Dili: Timor-Leste has turned a new page in its fight against diseases like tuberculosis, malaria, and HIV with the rollout of the Integrated Case-Based Electronic Surveillance System (ICBS-TL). This digital tool, which aims to shift the country’s reliance from aggregate data sets to case-specific information, is considered a paradigm change.
Simply put, instead of just tracking total case numbers, the new digital system provides a more detailed insight into individual patients’ situations. For years, work on tuberculosis, malaria and HIV in Timor-Leste has relied on aggregate numbers—cases summed up in broad strokes, offering limited detail on individual patients. But now, ICBS-TL will change that.
To support this transition, WHO and the Ministry of Health began training hundreds of healthcare workers across Timor-Leste in October to enter detailed case data into the ICBS-TL system. By December, health workers from all 13 municipalities successfully completed their training. Following the implementation, the WHO teams are also working with MOH to gather feedback and make improvements.
A digital data tracking system like ICBS-TL gains even more significance as Timor-Leste strengthens its detection and surveillance systems. According to the WHO Global TB Report 2024, the country recorded 6,171 tuberculosis (TB) cases in 2023—the highest on record, an outcome of better screening. Meanwhile, Timor-Leste is also on the verge of eliminating malaria, underscoring the importance of this precise and proactive tracking tool.
Few least developed countries have adopted case-based tracking, and even fewer possess the technology to support it. The ICBS-TL system collects detailed information, including each patient’s name, address, testing method, and type of tuberculosis or other diseases they are battling. For malaria and HIV, relevant data is similarly inputted.
“Switching from aggregate to case-based tracking is a big leap forward for healthcare in Timor-Leste,” said Dr Arvind Mathur, WHO Representative. “The ultimate goal is to go paperless and ease the load of paperwork for healthcare workers,” he explained. “With an advanced digital tool, they will be able to focus on what really matters—spotting cases early, getting people diagnosed and treated on time, and ensuring they complete treatment," Dr Mathur added.
The interactive ICBS-TL dashboard can deliver analytics for tuberculosis, HIV, and malaria at the click of a button, enabling the Ministry of Health and respective programs to precisely track patients, including their specific locations. This effectively facilitates the next steps such as contact tracing, monitoring, and follow-ups, ultimately leading to better disease management —all while ensuring secure data storage.
Since the ICBS-TL system became operational, he says, having an interactive dashboard at his fingertip has been a big advantage. “Even in these early stages, I could access detailed age, gender, and test-specific data with ease,” he said. 
With each entry, patterns begin to emerge, allowing programs to detect trends across municipalities and districts in real-time.
Sitting intently before his screen, Dr Felix Salsinha, a TB program coordinator in Ermera municipality, carefully entered case data into the ICBS-TL, following guidance from recent WHO-led training sessions. He believes that ICBS-TL would significantly boost efficiency and streamline processes. However, he added, true efficiency gains would depend on improvements in internet connectivity and the overall online infrastructure. A major advantage of ICBS-TL is that local health workers no longer need to manually aggregate data. As they enter case-specific information directly into the mobile application, the system automatically consolidates it. Additionally, the ICBS-TL platform integrates data from mobile TB vans and TB vulnerability assessment systems, providing an extensive view of TB cases across the country.
Powering ICBS-TL is the District Health Information Software 2 (DHIS2), an open-source health information management platform developed by the University of Oslo over 20 years ago to collect, manage, and analyze health data. DHIS2 is deployed in over 70 countries, primarily in low- and middle-income regions across Asia, Africa, and South America.
Sr. Costantino hopes that as more health professionals become acquainted with the web and mobile versions, efficiency will continue to improve. “The biggest impact will be the ability to generate high-quality data from the ground,” Sr Costantino summarized.