India carries the highest burden of TB in the world – an estimated ~3 million new cases and a staggering ~ 420,000 deaths are reported annually and Government of India (GOI) has set itself an ambitious goal of making India TB free by 2025 and USAID is also committed globally to end TB and initiated the USAID-India End-TB Alliance announced at the UN General Assembly in September 2018. In this area, PAHAL is designing and delivering various initiatives aligned towards the eradication of TB.
One such initiative is accelerating the promotion of the Corporate TB Pledge (CTP), a joint initiative of Ministry of Health and Family Welfare (MoHFW) and USAID/India to catalyze the corporate sector with its vast pool of resources, management skills and reach among workers & communities to play vital role in TB prevention and care.
COVID-19 Challenge and Response of
Government of India (GoI)
In the current situation where the globe is struck with a pandemic, COVID-19 cases, the Government of India (GOI) is taking measures focused on strengthening health systems for equitable service delivery to address current and future needs. At the national level, the Ministry of Health and Family Welfare (MoHFW) is leading the overall response to COVID-19. The MoHFW is focusing on improving health system preparedness through facility and infrastructure strengthening, risk communication, and trainings of government health providers, amongst others.
In addition to the measures taken by the Government of India, National Health Authority (NHA) through Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY) is uniquely positioned to provide need-based support during the COVID-19 crisis. To its advantage, NHA has currently 11,000+ government and 9000+ private facilities empanelled and has access to other private sector providers desirous of contributing to GOI efforts.
The connect between COVID-19 and TB
COVID-19 being a respiratory tract infection caused by a newly emergent coronavirus, makes those with pulmonary TB having any damage to lungs possibly more vulnerable. Additionally, the symptoms of COVID-19 can be similar to those of TB, with fever, cough and shortness of breath, but there is usually a difference in the time frame that the symptoms occur.
As per World Health Organization (WHO) it is anticipated that people ill with both TB and COVID-19 may have poorer treatment outcomes, especially if TB treatment is interrupted. There are other similarities between the two as well like preventive measures of wearing a mask, maintaining hygiene and associated stigma, both being communicable diseases. Further, in a recent development, Indian Council for Medical Research (ICMR), has allowed use of diagnostic machines used to test drug-resistant tuberculosis (TB) for conducting Covid-19 tests.
The PAHAL Response to Crisis
National Health Authority (NHA) has reached out to the USAID to seek its technical expertise in rapidly establishing a financing mechanism that will enable it to respond to COVID-19 and other emerging public health threats. The approach is focused on using blended finance to meet the additional resource requirements of stakeholders along the entire value chain, from commercial validations of technology, manufacture and supply chain, to patient care, follow up and awareness building. It is proposed to structure and manage a blended finance facility for this purpose under NHA’s leadership.
Given, PAHAL’s work in blended finance solutions and given the need for continued focus on TB prevention and care during COVID-19 pandemic, it presents a unique opportunity for the project to provide support to NHA in this endeavour. In this collaboration, PAHAL can bring in technical expertise and experience in communicable disease management, risk communication and blended financing. PAHAL can also support in mobilizing Corporate TB Pledge members which currently stand at close to 100 to additionally work in area of COVID-19.
PAHAL is USAID/India and IPE Global’s flagship innovation in financing platform focused on private sector involvement in primary healthcare provision. The primary objective of PAHAL is to increase access to affordable primary healthcare to 10 million urban poor and reduce out-of-pocket expenditure (OOPE) for Urban Poor for Primary Health Care by 30% in program areas. In order to achieve the above objectives, amongst other initiatives IPE Global, under USAID’s Cooperative Agreement is implementing a project titled “Ending Preventable Maternal & Child Deaths Among Urban Poor Project” also known as “Partnerships for Affordable Healthcare Access and Longevity” (PAHAL). The project is closely aligned with Government of India’s focus on ending tuberculosis (TB).