Public Private Mix (PPM) Models for the Sustainability of SuccessfulTB Control Initiatives

Overview

TB is concentrated in lower income populations; its control is a public good that requires financing. A range of strategies are needed to finance various context-specific public private mix (PPM) models in TB, and new mechanisms represent a significant opportunity. Sustainability of such financing relies in part on the incorporation of TB and PPM into domestic health financing streams. Currently, the predominant source of financing for PPM is input-based domestic and donor financing, but countries are increasingly exploring output or results-based financing (RBF) and financing via health insurance agencies. Social protection programs can also supplement with patient enablers. Some TB services and financing streams are better matched (e.g., direct medical services may be covered by insurance payments) but this leaves community activities to core government budgets. As such, the field needs a range of tools and schemes that can be adapted to produce the optimal PPM for each country’s context. Whatever mix of financing is used, pooling of the financial resources is a critical step to reduce complexity and standardize service packages.