The Indian Council of Medical Research (ICMR), under its India TB Research Consortium initiative, will soon begin a programme for developing/ scaling up innovative, cost effective and sustainable models to engage the private sector for elimination of tuberculosis (TB) in the country.
In this regard, the ICMR has now solicited concept proposals from qualified implementation research/ corporate organizations to develop/scale up cost effective, innovative and sustainable models towards engaging the private sector for TB elimination which would have high potential of integration in the programme. Proposals are solicited for the various areas involving/not involving Information and Communication Technology (ICT) tools. These areas include increasing notification of TB; improving the diagnostic efficiency within the private sector by using advanced molecular diagnostics methods/microbiologically confirmed TB; providing free drugs through e-vouchers; innovative means of engaging informal providers; improving treatment adherence; increasing patient support; and any other innovative mechanism to engage the private sector.
The proposal can belong to any of the two categories---developing a cost effective, innovative and sustainable model; and intervention which has been successful at the pilot stage in the country and which can be scaled up in a cost effective and sustainable manner for effective large scale implementation by the RNTCP/government institutions.
Implementation research organizations; non-governmental organizations; other research organizations with prior experience in implementation research; hospitals with necessary expertise; and corporate organizations/ hospitals with necessary expertise are eligible to be part of this programme. The last date for applying is August 20, 2017.
The ICMR's initiative is significant because despite mandatory notification for reporting cases of TB, many patients are still not reported to the Revised National Tuberculosis Control Programme, (RNTCP). This is because a majority of patients afflicted with TB are seeking care in the private sector resulting in about 1.5 million missed cases. Therefore, there is an urgent need to address this issue and accelerate the efforts towards strengthening case notification, reducing diagnostic delays and improving treatment outcomes of patients going to the private sector.
The massive private healthcare sector coupled with the vast heterogeneity (comprising qualified and unqualified practitioners) further aggravates this problem. Recently, many innovative pilot initiatives to improve diagnosis, notification and treatment practices for TB by the private sector have been developed and tested in various parts of the country. Because of such pilot initiatives, private sector practitioners have been using various ICT tools to notify TB cases and ensuring that the patients receive e-vouchers for free and appropriate drugs. It has become evident that ICT tools have been extremely instrumental in engaging the private healthcare providers towards facilitating TB notification and improving treatment outcomes. Optimization of the usage of such ICT tools is extremely important. The innovative models have engaged the private sector and aided in bringing the privately treated TB patients towards public health services, where care and adherence can be monitored.
While the models implemented in the country have shown success in a particular zone/ or state (s)/cities; they have not been replicated or have not found to be replicable in other states due to not being cost effective or because of sustainability issues. This has been a limiting factor in the large scale implementation of models across the country or for incorporation into the RNTCP. Thus, there is a dire need of having cost effective and sustainable models to engage the vast diversity of private healthcare providers in the country which could be scaled up further and finally incorporated into the RNTCP or be taken up by government institutions.