Strengthening Tuberculosis Care in India: Public-Private Integration and Policy Innovations

Tuberculosis (TB) remains a major public health challenge in India, accounting for over 25% of the global burden. While public hospitals provide free TB treatment, they often lack a patient-friendly environment. In contrast, private hospitals offer better facilities but lack standardized treatment protocols, increasing the risk of drug-resistant TB. Addressing these gaps requires a well-structured Public-Private Partnership (PPP) to ensure accessible, quality-assured, and patient-friendly TB care.

Challenges in Existing Healthcare System

• Public hospitals: Free treatment but perceived as inefficient and overcrowded.

• Private hospitals: Better facilities but inconsistent protocols and high costs.

• Drug-resistant TB (DR-TB): Restricted medicines available only in public hospitals.

• Lack of coordination: Patients switching between sectors disrupts treatment adherence.

Key Reforms to Strengthen TB Care

Public-Private Integration

• A PPP model with uniform treatment protocols and government-supervised drug distribution.

• Private hospitals can provide better patient experiences, while the public sector ensures treatment accountability.

Shorter and Effective Treatment Regimen

• Introduction of the BPaLM regimen reduces treatment duration from 24 months to 6 months.

• Eliminates painful injectables, improving adherence and recovery rates.

Strengthening Diagnosis and Accessibility

• Molecular tests (CBNAAT, TrueNat) ensure rapid, accurate TB detection.

• Ayushman Arogya Mandirs (AAMs) act as decentralized sputum collection centers, increasing rural access.

Enhanced Nutritional and Financial Support

• Ni-kshay Poshan Yojana (NPY) support increased from ₹500 to ₹1,000 per month, aiding malnourished TB patients.

• Expansion of social protection schemes to compensate wage loss during treatment.

Community Engagement and Stigma Reduction

• TB Champions (survivors) share experiences, encouraging early diagnosis and adherence.

• Large-scale awareness campaigns can reduce stigma and misinformation.

Integrating TB Care with General Health Services

• AI-enabled chest X-rays for early detection of TB and coexisting conditions like COPD.

• Gender-responsive healthcare strategies to address access barriers for women and vulnerable groups.

Conclusion

A comprehensive, patient-centered approach is essential to eliminate TB in India. Public-private integration, standardized treatment, stronger financial support, and community-driven awareness will accelerate India’s fight against TB and set a global benchmark in healthcare.