India: Unique initiative with private practitioners against MDR-TB

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Central role for private practitioners in unique partnership against drug-resistant TB in Chennai, India.

KNCV Tuberculosis Foundation is partnering with Lilly MDR-TB Partnership, REACH and India’s national TB program (RNTCP) to offer the population of Chennai rapid, accurate diagnosis for TB and drug-resistant TB.

The fight for a TB-free India continues to gain ground with the launch of an innovative project in the city of Chennai. Patients of private health practitioners are to be offered rapid, accurate diagnosis for TB and drug-resistant TB. The project EQUIP, which stands for Enhanced use of Quality drugs and Utilization of Innovative Diagnostics for TB Management in the Private Sector, is creating a public-private partnership to ensure that private sector health providers and their patients will have access to free TB testing with the latest technology.

EQUIP seeks to demonstrate that the private sector in India can be a big part of the solution for a TB-Free India. The Lilly MDR-TB Partnership, KNCV Tuberculosis Foundation, and local non-governmental organization REACH (Resource Group for Education and Advocacy for Community Health) are joining forces with India’s TB control program (RNTCP) in this unique collaboration.

Giving patients free access to the new GeneXpert laboratory test allows for early diagnosis of TB and detection of drug-resistance. This means that we can save more lives and prevent others from becoming infected. This is the first time that a collaboration with the private sector has focused specifically on the growing problem of multidrug-resistant TB (MDR-TB) in India.

Implemented by REACH, with technical support from KNCV and funding from the Lilly Foundation and United Way Worldwide, the pilot project will operate in Central and South Chennai for the next 12 to 16 months to demonstrate the potential for private health providers to contribute to early detection of TB cases and successful treatment of drug-resistant TB.

The EQUIP model was developed in collaboration with the private providers and the patients. Focus group discussions and one-on-one meetings were held with chest physicians, general practitioners, specialists and current TB patients in Chennai, to understand what they need in order to participate in the effort and contribute to a TB-Free India. The response was overwhelmingly positive. REACH hopes that early adopters within the private provider community will inspire their colleagues to join the fight.

EQUIP will provide the participating health providers and their patients with access to free chest x-rays and GeneXpert tests at convenient locations. For those diagnosed with TB or drug-resistant TB, the project will work with the national TB program to provide high-quality, effective medicines to cure the disease, and support to patients to help them complete their full course of treatment. Results will be used to develop a replicable model for scale-up across India, in collaboration with RNTCP and other organizations testing models for engaging the private health sector.

EQUIP at-a-glance

The Problem: India has the highest number of MDR-TB cases in the world. Most of the people with MDR-TB go undetected, while others are diagnosed only after they have failed their initial TB treatment. This leads to unnecessary illness and death, and the spread of MDR-TB to others. The private sector is often the first point of care for people with TB symptoms, but lack of strong linkages with the national TB program and access to the latest diagnostics and treatment mean that private sector patients may not be recognized and treated as quickly as they could be.

Project Goal: To develop an effective and replicable model for public-private partnership in diagnosing, notifying, and ensuring early access to care for people with drug-resistant tuberculosis. By working with private providers and supplying free access to rapid diagnostic technologies, quality drugs, and treatment support for their patients, we hope to decrease the time it takes to properly diagnose MDR-TB, ensure the right treatment, and reduce the costs to patients.

Project Scope: This project will focus on licensed general practitioners and chest physicians in Chennai and their TB patients. KNCV is partnering with two organizations in India to form the research and implementation team for the project: the Central TB Division (CTD) of the RNTCP and the Resource Group for Education and Advocacy for Community Health (REACH).

Project Plan: Initial steps will include identifying key stakeholders among private providers in Chennai to hold focus group discussions, evaluating and refining the partnership model. A project advisory group composed of private provider representatives, local RNTCP, community and patient representatives, and research institutes will guide the project. Following implementation and evaluation of interventions, results are anticipated to be reported at the 2016 IUATLD (the Union) Conference and key annual meetings in India.

This project is supported by a United Way Worldwide grant made possible by the Eli Lilly Company Foundation (Lilly Foundation) to KNCV Tuberculosis Foundation.

A United Way Worldwide grant made possible by Eli Lilly and Company Foundation (Lilly Foundation)

See also the guest blog by Agnes Gebhard about KNCV’s partnership with Lilly in the MDR-TB Partnership.

EQUIP project, Chennai, India. DOT Supervisor Joseph Soundararaj. Photo by Netty Kamp


Laboratory staff at PPM center, Hindu Welfare Hospital in Central Chennai, participating in EQUIP project REACH. Photo by Netty Kamp.

Photos © Netty Kamp, KNCV.