Global Fund - Tuberculosis Information Note

GLOBAL FUND - INFORMATION NOTE (July 2019) - please click to see the full document

This Information Note provides guidance to applicants preparing a Global Fund request for tuberculosis (TB) funding. It makes recommendations on setting priorities and targets for TB interventions that will achieve the highest impact. It promotes strategic investments to save lives and achieve economic benefits, based on the country’s TB situation and other contextual factors including the health system:

• Its TB profile: both drug-susceptible [DS-TB] and drug-resistant TB [DR-TB];
• The health system context of the country.
• Existing human rights and gender-related barriers and;
• Socio-economic and other structural barriers to accessing TB services

The note is also useful for countries preparing or revising their TB national strategic plans (NSP).

---- A few specific highlights related to Private Sector engagement:

p.6: Private Sector TB Care. In some countries, most of TB/DR-TB patients consult private providers for their TB-related symptoms. Private care providers include general practitioners, physicians, private pharmacies, private laboratories, traditional healers, and others. Engagement of these care providers in TB diagnosis, treatment and prevention is very critical. Innovative approaches to engage and collaborate with them including through involvement of interface agents and by providing incentives should be explored and integrated into the effort in fighting TB. Mandatory notification and simplification of the recording and reporting system including through electronic/digital systems facilitates engagement of private providers and maximizes their contribution to ending TB.

p.11:  Engaging private providers

As highlighted in the public-private-mix (PPM) Landscape Analysis (Global TB report, 2018), 62 percent of the 3.6 million “missing people” with TB lived in seven countries in which private providers accounted for more than two-thirds of patients initial care-seeking. However, in these countries, private for-profit providers contributed just 19% of the total TB notifications, which is equivalent to only 12% of the estimated TB incidence in 2017. Global Fund support for PPM activities in these countries has more than doubled during the second funding cycle, with new principal recipients added in some of the countries. To close treatment coverage gaps and ensure early access to diagnosis and treatment, strengthened and expanded engagement of private (for- and not-for-profit) providers is required. Innovative approaches to engage and collaborate with private care providers should be explored and integrated into efforts to fight TB; this can include the use of interface agents, as is being implemented in India and others, providing monetary and/or non-monetary incentives, among other approaches. Mandatory notification and simplification of the recording and reporting system, including through the use of digital systems, facilitates private provider engagement and maximizes their contribution to ending TB. These interventions may also be applicable to countries other than those seven countries, where the engagement and the contribution of private health care providers are important. Several countries, including India, Pakistan and Bangladesh, have good lessons learned from engaging the private sector in pilot projects. Other countries could also benefit from sharing those experiences. Strategies for engaging the private sector providers are outlined in the PPM roadmap, a Stop TB field guide, and in a concept note guiding TB REACH applicants.

Key References

Global Fund Information Notes and Technical Briefs (these are being updated/finalized and could be accessed at this landing page)