title: Global Fund financing of public-private mix approaches for delivery of tuberculosis care.
abstract: OBJECTIVE
  To map the extent and scope of public-private mix (PPM) interventions in tuberculosis (TB) control programmes supported by the Global Fund.
  
  
  METHODS
  We reviewed the Global Fund's official documents and data to analyse the distribution, characteristics and budgets of PPM approaches within Global Fund supported TB grants in recipient countries between 2003 and 2008. We supplemented this analysis with data on contribution of PPM to TB case notifications in 14 countries reported to World Health Organization in 2009, for the preparation of the global TB control report.
  
  
  RESULTS
  Fifty-eight of 93 countries and multi-country recipients of Global Fund-supported TB grants had PPM activities in 2008. Engagement with 'for-profit' private sector was more prevalent in South Asia while involvement of prison health services has been common in Eastern Europe and central Asia. In the Middle East and North Africa, involving non-governmental organizations seemed to be the focus. Average and median spending on PPM within grants was 10% and 5% respectively, ranging from 0.03% to 69% of the total grant budget. In China, India, Nigeria and the Philippines, PPM contributed to detecting more than 25% TB cases while maintaining high treatment success rates.
  
  
  CONCLUSIONS
  In spite of evidence of cost-effectiveness, PPM constitutes only a modest part of overall TB control activities. Scaling up PPM across countries could contribute to expanding access to TB care, increasing case detection, improving treatment outcomes and help achieve the global TB control targets.
authors.affiliation: The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland  Stop TB Department, World Health Organization, Geneva, Switzerland. lal.sadasivan@theglobalfund.org
authors.forename: S S
authors.initials: SS
authors.lastname: Lal
authors.forename: Mukund
authors.initials: M
authors.lastname: Uplekar
authors.forename: Itamar
authors.initials: I
authors.lastname: Katz
authors.forename: Knut
authors.initials: K
authors.lastname: Lonnroth
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Komatsu
authors.forename: Hannah Monica
authors.initials: HM
authors.lastname: Yesudian Dias
authors.forename: Rifat
authors.initials: R
authors.lastname: Atun
mesh_terms: D003695:Delivery of Health Care / Q000191:economics*; D005380:Financing, Government / Q000191:economics; D006801:Humans; D007391:International Cooperation; D017149:Private Sector / Q000191:economics; D055818:Public-Private Sector Partnerships / Q000191:economics; D014376:Tuberculosis / Q000628:therapy*