Tuberculosis is easily one of India’s most critical public health issues, but TB prevention and control efforts face several challenges. Of these, perhaps the most significant is the effective engagement and participation of India’s vast private sector, which manages 60 per cent of all TB patients.

The private sector is highly fragmented and consists of providers of variable quality. Many TB programme managers may perceive the private sector as their main challenge and feel that engaging them would be outside the scope of their mandate. This detachment between the public and private sector is unproductive and fuels further spread of TB. Patients regularly float from one sector to the other, expending their resources and becoming more and more ill. There is also increasing evidence of a rise in the rates of drug-resistant TB — an indication that all is not well with the management of TB patients in the community.

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Engaging the private sector in TB control