Half of patients with chronic disease do not take their medicines as prescribed, and the burden falls hardest where research is thinnest. We train and fund researchers in low- and middle-income countries to find out why, and we publish what they learn openly so treatment works where it is needed most.
An estimated 125,000 deaths and $300 billion in avoidable healthcare costs occur annually in the United States alone because patients do not take their medications as prescribed.
Between 30% and 50% of patients with chronic conditions do not adhere to their prescribed regimens. Yet most programs treat every missed dose the same way, although the causes differ.
Knowing why a patient stops is what makes the right help possible. That evidence is scarcest in low- and middle-income countries, where chronic disease is rising fastest.
Sources: World Health Organization, Adherence to Long-Term Therapies: Evidence for Action (2003); Osterberg & Blaschke, New England Journal of Medicine 353:487 (2005).
Driven by beliefs, distrust, perceived side effects, or calculated risk. Responds to motivational and behavioral intervention.
Caused by forgetfulness, complexity, access barriers, or system failures. Requires structural support and simplification.
MAP (Multidimensional Adherence Parameters) is the eight-item instrument TESSERA GRC is built around: a familiar 0 to 8 score plus an Architecture, Execution and Context profile. PEACS, a separate exploratory instrument, tracks longitudinal behavioral profiles.
We fund adherence research led by local investigators, publish what it finds openly, and work with communities to act on it. Three programs, one aim: evidence from the places that need it most, shared with everyone.
Full or partial funding for adherence studies led by graduate students and early-career researchers in low- and middle-income countries. Every grant includes full access to ATLAS for the study (donated in kind by Adherence Cartography), plus training and mentoring. Nothing to pay, ever.
How funding works →An open, citable reference for what adherence looks like by condition, country and population, so every study has a baseline to compare against. Every contributing site is credited. Volume 1 is in preparation.
About the publication →With local partners, we measure and improve adherence where care actually happens. Our first is ADHERE, a stroke-prevention adherence program in Ghana led by SASNET-Ghana with the Ministry of Health and Ghana Health Service, launching on World Stroke Day, October 29, 2026.
Partner with us →Good adherence studies in low-resource settings usually stall on small, practical costs. TESSERA Research Grants fund those studies, in full or in part, and give every grantee full access to ATLAS so that local researchers can run their own studies and publish under their own names. Grants are funded by donations to the Foundation, and donors can also endow a named one-year fellowship that carries one researcher’s study from fieldwork to publication.
Graduate students and early-career researchers at institutions in low- and middle-income countries.
Full ATLAS access for the study, plus full or partial funding of study costs: fieldwork and data collection, participant travel, translation, ethics review fees and open-access publication.
The Foundation’s board reviews every application. Each award will be published on this site with the researcher, country and amount.
All three programs run through TESSERA, our research consortium. A tessera is a single tile in a mosaic: each researcher and site adds one, and together they form a picture of adherence no single study could show. Individual membership is free. See the mosaic →
The TESSERA Annual Normative Publication will be a peer-reviewed, open-access scientific reference that every researcher using MAP, PEACS, or MMAS-8 can cite. Published by the Scala Carta Foundation. Co-authored by consortium contributors. Freely available to all.
The TESSERA normative publication draws on the ATLAS Global Dataset, made available to the Foundation by Adherence Cartography for open science, together with data that sites contribute directly through the TESSERA template. It captures MAP Predictive Emergence (PE) scores and PEACS profiles across sites and countries. It answers the question every adherence researcher eventually asks: what is actually normal for this condition, in this region, in this population?
The TESSERA Normative Publication is designed to answer it at global scale, with every contributing site credited.
Every contributing site, whether its data comes through the ATLAS Global Dataset or the TESSERA template, has its investigators listed as consortium co-authors on the annual publication when they meet ICMJE authorship criteria, whatever their membership type. The minimum contribution threshold is 30 MAP assessments from a documented patient cohort.
Most studies define their own baseline. TESSERA builds a shared one that any study can be compared against.
Most normative references are single-site or single-country. TESSERA aggregates prospective clinical data from contributing sites in many countries, building toward a global adherence reference.
A DOI-assigned, peer-reviewed normative reference can anchor the rationale section of any NIH, Wellcome, or Fogarty grant. Reviewers recognize a citable norm as scientific infrastructure.
Your gift funds TESSERA Research Grants, fieldwork in low-income settings and the open normative publication. Scala Carta Foundation is a 501(c)(3) public charity, and gifts are tax-deductible to the extent allowed by law.
Covers a year of training and mentoring for an LMIC graduate student: MAP certification, PEACS training, and mentoring through the Research Exchange.
Funds data collection support for an independent LMIC investigator: fieldwork costs and help preparing a contribution to the normative dataset.
Partners with a clinical team in a low-income country to run a full MAP validation study: instrument deployment, data collection support, and co-authorship for the local team on the TESSERA normative publication.
Endows a named fellowship for one year: funds one LMIC researcher's study from data collection to publication. The fellowship carries your name.
Request InvoiceThe Foundation is classified under IRC §170(b)(1)(A)(vi) as a publicly supported organization. This means:
Contributions are fully tax-deductible, effective retroactively to June 12, 2026.
Grants from Fidelity Charitable, Schwab, Vanguard, and other DAFs are eligible without restriction.
Private foundations can grant to the Foundation without expenditure responsibility requirements.
Can apply for NIH, Fogarty International Center, PCORI, and WHO-affiliated grant funding.
For wire transfer, institutional giving, or custom amounts, contact [email protected]
Scala Carta Foundation · IRS-Confirmed 501(c)(3) · EIN 42-3133499 · All donations are tax-deductible
Students, early-career and unfunded researchers apply once, at no cost. Researchers at institutions in low- and middle-income countries are considered for a TESSERA Research Grant in the same application.
Complete the application below: about ten minutes, with your institutional email and a short statement about your patients and your question.
The Foundation reviews every application within five business days. Approved members receive a membership letter; grant recipients also receive training and ATLAS access, donated in kind by Adherence Cartography.
Complete MAP certification, run your study, and contribute data to the normative publication. Co-authorship follows contribution, on the same terms for every member.
Institutional Partners become a named TESSERA site and receive a guided MAP cross-cultural validation protocol, study design support from the Foundation's advisory team, and regular benchmarking reports. Annual partnership dues support the Foundation's programs, with a reduced rate for institutions in low- and middle-income countries.
Applications are reviewed within five business days. You will receive a formal membership confirmation from the Scala Carta Foundation.
The Board reads this when considering eligibility for the TESSERA LMIC Grant. Tell us who your patients are, what medication adherence challenge they face, and why this evidence is scarce or absent in your setting. Specific and honest answers carry more weight than broad statements of intent.
Thank you for applying to TESSERA GRC. Your application has been submitted to the Scala Carta Foundation for review. A confirmation email will arrive within 24 hours, and a decision within five business days.
Scala Carta Foundation is a 501(c)(3) public charity (EIN 42-3133499), classified under IRC §170(b)(1)(A)(vi) and registered with the California Attorney General's Registry of Charitable Trusts. Our annual Form 990 will be published here once filed.
Our founder, Philip Morisky, also founded Adherence Cartography, the company that develops ATLAS and MAP. Adherence Cartography donates ATLAS access for our grant recipients and makes its de-identified Global Dataset available for our open publication. The Foundation does not pay Adherence Cartography, and conflicts are managed under our conflict-of-interest policy.
We work only with de-identified data. How data is attributed, retained and shared across jurisdictions, including GDPR, the UAE PDPL and HIPAA, is set out in the TESSERA Data Governance Charter. Request the Charter.
Scala is a scale, something you measure with. Carta is a map or a charter. Together: a measured map of how people live with their treatment, drawn by the people closest to it.