Private and Public Partnerships for TB

1. Private and Public Partnerships for TB Discussion points

2. Private and Public Partnerships for TB • Several thousand partners globally • Wide range of partners involved • Significant contribution to national TB control efforts (25% increments in case detection; increase in treatment success rates; shorter diagnostic delays, better treatment adherence)

3. What has worked? some examples • Intensified training of private and public providers to develop, implement and evaluate joint approaches • Establishing forums for coordination, collaboration, networking • Clear definition of roles and responsibilities; sharing of responsibilities, Memoranda of Understanding • Franchising, social marketing • Inclusion of private laboratories in diagnostic network • Establishing referral networks • Endorsement of the International Standards of TB Care by professional bodies • Pooling of resources- human, financial, infrastructure • Joint monitoring and evaluation • Support for community support groups “ A strong and willing public health programme is key”

4. How can the private sector scale up participation? • Create own networks to work with each other and with the NTP • Peer sensitization, advocacy, monitoring • Document and disseminate best practices for wider replication • Medical technology, pharmaceutical firms can contribute beyond R and D; application of “corporate social responsibility” in communities • Fostering innovative approaches

5. Common barriers Within the NTP: • Limited ability (staff time, capacity, motivation) • Limited networking, systematic approaches to involving private providers • Sustaining quality while expanding PPMa challenge (limited capacity for constant interaction, supervision/lack of forums to jointly address issues Within participating sectors: • Lack of information; Ideological differences- diverse group of providers—each requires a different approach • Reluctance to refer for diagnosis and treatment: uptake and sustaining of PPs’ interest in collaboration • Poor patient retrieval: limited referral links with community centres • Supervision by NTP staff not always well received • “Lack of ownership”

6. Solutions: strategies • Systematic approach,learning from pilots, revision of strategies, “structured approach”, packaging • Approach through professional societies and one-to-one peer sensitization • Establishing national networks, forums for regular interaction, improving service delivery • Strong leadership, flexible support by national programmes • Prioritization:which partners to involve and when, to maximally and rapidly benefit from partnerships

7. Solutions: strategies • Establishing interfaces, common forums to resolve issues, build mutual trust • Well defined transparent mechanisms for peer reviews, dissemination of experiences • Promotion of the use of the international standards of TB care • Sustained efforts to train, orient different providers, —adapting to needs, perceptions; pre-service training • Non financial incentives: recognition of contribution by private providers

8. Which areas could the private sector engage in more? • Raising political commitment for TB control • Setting policy, standards for PPP practices, mapping roles and responsibilities • Extension of services into workplaces, hospitals • Extension of Quality assured laboratory services SM, Culture and DST • Training, capacity building, counseling • Specialized care for complicated cases (eg., MDR-TB cases, adverse reactions) • Research and development • Advocacy, social marketing, increasing community awareness • Funding??

9. Facilitating co-investments: what can NTPs do? • Widely inclusive approach • Building on strong support, leadership by NTPs and contributions by partners • Documentation, dissemination, recognition of best practice examples to facilitate scale –up, adoption by other sectors • Greater engagement with corporate sector– regular interaction, attractive effective messaging to CEOs, addressing business interests, supported by technical support, clear guidelines for implementation • Inclusion of TB control in business plans of corporate organizations; learn advocacy from HIV!!