Tuberculosis (TB)

First-ever targeted roadmap outlines steps to scale-up public-private health sector engagement to end TB

WHO SEARO/David Orr

The World Health Organization (WHO), the Public-Private Mix Working Group of the Stop TB Partnership, and global partners have just released a Roadmap to scale up the engagement of public and private health care providers in efforts to end TB. The roadmap was jointly launched by Dr Tereza Kasaeva, Director of the WHO Global TB Programme and Dr Madhukar Pai, Chair of the Public-Private Mix (PPM) Working Group & Director of McGill International TB Centre, together with countries and partners. It identifies clear actions needed to expand the engagement of all care providers towards universal access to care, building on a Landscape Analysis of the private health sector on TB that was also simultaneously released.

“We have the momentum and commitment to reach all people with quality TB care, as countries gear up to reach the targets of the recently adopted Declaration of the UN High Level Meeting on TB,” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme. “Working together with private and unlinked public health care providers - who are often the first point of care for people with TB in countries - is critical to close gaps in care. The PPM roadmap and landscape analysis are important documents to advocate for and guide action on this issue.”

“The PPM Working Group is fortunate to have excellent partners and experts who have put together the Roadmap and Landscape”, said Dr Madhukar Pai, Chair of the PPM Working Group. “We now urge high burden countries to use them to scale up PPM interventions, to find missing patients as well as improve quality of care in the private sector. I see PPM as the best strategy to find missing patients in countries with large, dominant private health sectors”.

The launch of the first PPM Roadmap & landscape analysis follows increasing awareness on the urgent need to address the issue of reaching the missing people with TB with care. According to WHO’s latest Global TB Report, 3.6 million of the estimated 10 million people with TB worldwide were “missed” by national TB programmes in 2017. Two thirds of them are thought to access TB treatment of questionable quality from public and private providers who are not engaged by the NTP. The quality of care provided in these settings is often not known or substandard. Closing these gaps and ensuring patient-centred care imply that quality-assured and affordable TB services must be made available wherever people choose to seek care.

The Roadmap recommends ten actions at national and global levels to scale up the engagement of all care providers towards universal access to care:

The roadmap also contains a timeline with targets for 2020, 2022, 2025 and 2030, to showcase contribution to global End TB targets.

Dr Jacob Creswell, Team Leader, Innovations and Grants from the Stop TB Partnership also presented a new field guide that includes a compilation of tools, experiences and examples in implementing effective TB case-finding interventions, especially from TBREACH. “This Field Guide is one of 11 that is meant to bridge the gap in between the high level guidelines and implementation in the field. They have been developed under Global Fund’s Strategic Initiative on finding the people with TB who are missed, said Dr Creswell. “We hope that it is a useful tool for different program implementers to help plan, design and monitor the results of their interventions with the private sector”.

As countries move towards Universal Health Coverage (UHC) and reaching the TB-related targets in the Sustainable Development Goals and End TB Strategy, they need to harness the full potential of private providers. TB programmes can be pioneers in this area by accelerating the strategic engagement of private health care providers.