Tuberculosis (TB) remains a major public health problem in the regions of East, Central, and Southern Africa (ECSA). Because TB is an airborne disease, its transmission is facilitated by the movement of people across internal and national borders. To operationalize the TB control strategy in ECSA countries, USAID, through Challenge TB and MSH, has facilitated technical and financial support for pilot cross-border TB interventions that span the region, including border areas. Among the challenges requiring intervention were prompt detection and treatment of TB among mobile populations crossing the borders, harmonization of TB treatments, and design and implementation of a supply chain information system. To harmonize cross-border treatment of TB patients crossing country borders in the ECSA regions, in 2015 member countries agreed to a regional, web-based supply chain information system that tracks patient and stock information and shares it among member countries to support evidence-based decision making.