# Building sustainable TB care systems: managing incentives in private sector engagement

## TL;DR

Engaging the private sector with proper incentives improves TB care, but transitioning to government-led systems is crucial for long-term success.

## Contribution

The paper highlights how combining financial and non-financial incentives in private sector engagement can improve TB care outcomes.

## Key findings

- Non-financial incentives combined with financial ones improve TB notifications and treatment outcomes.
- Government-led systems are essential for sustaining TB care improvements.
- Payment delays and donor dependency threaten the sustainability of TB programs.

## Abstract

Private sector engagement (PSE) plays a vital role in enhancing TB care. Global Fund-supported PSE activities contributed to improved TB notifications and treatment outcomes, especially where non-financial incentives were complemented by financial incentives, delivered directly or via social health insurance. Transitioning such activities to government-led health systems is essential for long-term sustainability and to end TB. Well-designed incentive strategies could ensure quality care where patients seek services. However, payment delays, administrative burdens, and donor dependency threaten sustainability. Governments need to address these challenges to transition programs into people-centered, integrated primary healthcare systems, ensuring access to training, diagnostics and program drugs.