Innovating TB Care Delivery in High-Burden Settings

April 15, 2015

Summary

Over 65 experts convened for the Innovating TB Care Delivery in High-Burden Settings workshop. This workshop was hosted by the newly established Harvard Medical School Center for Global Health Delivery- Dubai, in Dubai, United Arab Emirates. The workshop’s aim was to gather experts in TB detection and treatment to discuss innovations found in the private sector in high-burden countries that may be utilized to strengthen TB programs and create viable new TB treatment models. This meeting addressed the significance of the private market for TB care in key countries, and how the strengths of both public and private sector approaches may be synthesized in an effective way to combat TB, while continuing to prioritize accountability and the prospects for scaling up such approaches.

The workshop brought together 63 providers, researchers, policy-makers, and industry representatives from more than 15 countries across Asia, Africa, the Americas, and Europe. Meeting participants were from non-governmental organizations, academic research institutions, national and global organizations, and pharmaceutical companies. Represented organizations included the Clinton Health Access Initiative, Partners In Health, the Global Fund to Fight AIDS, Tuberculosis and Malaria, Interactive Research and Development, the Aurum Institute, Pakistan’s National TB Program, the Organization of Eastern Caribbean States (OECS), Stellenbosch University, Stop TB Partnership, and Janssen Global, among many others.

The global struggle against both drug-susceptible and drug-resistant TB has largely focused on programmatic and clinical responses to the disease through the public sector, given that the populations most likely to be affected by TB are those situated within particularly challenging socio-economic and public health environments. With highly expensive diagnostic tests and drugs, complicated treatment regimens and significant side effects, TB patients often cannot be expected to finance tests and medicines, or manage a full course of therapy. However, many patients in high-burden countries pay for tests through private laboratories and buy first and second line TB medications through private hospitals and pharmacies, with varying ad hoc regimens, utilizing drugs of unknown quality or without key drugs. The flexibility and innovation found in the private sector can be a significant factor in strengthening existing TB programs and creating viable new models.

Compelling presentations by Jacob Creswell from the Stop TB Partnership, Imran Zafar and Ali Habib from Interactive Research and Development, Luke Disney from the North Star Alliance, and Shelly Batra from Operation ASHA fueled discussions around responsible methods for utilizing new technologies and private sector resources to innovate TB case finding and care delivery in high-burden settings.

A report will be issued summarizing the presentations and the findings of the discussions on these topics. The report will emphasize when possible the practical potential applications of the findings, a sharing plan for future work where appropriate, and a brief summary of recommended practical interventions or policy reforms.