15 December 2018, Andhra Pradesh, India - Earlier this year Andhra Pradesh, home to 50 million people, was prestigiously recognized by the Indian Ministry of Health as the leading state in the battle against TB. Its diverse portfolio of innovative schemes has attracted global attention, most especially a bold approach of joining forces with Molbio Diagnostics, an Indian lab equipment company, to replace centuries-old diagnostic methods that are holding back progress in the long fight against the disease.
The Andhra Pradesh/Molbio public-private partnership has resulted in Molbio replacing sputum smear microscopy across the state with a small device utilizing Truenat - a contemporary test for early TB detection that also enables active case finding and universal drug sensitivity testing for Rifampicin. Crucially the portable device can be easily transported to operate in resource limited settings using rechargeable batteries, meaning it can overcome one of the more persistent barriers in global TB response – lack of access to accurate diagnosis. The successful replacement of microscopy is a significant milestone towards fulfilling the goal of early diagnosis in all people with TB and Treating Best at First.
Where the deal proves unique is the agreement by both parties wherein Molbio is responsible for the upkeep and functioning of the equipment, as well as overseeing other administrative functions such as training and data collection. These supply aspects relieve the national health service of prohibitive costs that usually accompany similar machines in the market. Meanwhile, Andhra Pradesh’s side of the bargain is simple. It has made a firm commitment to source and roll out the technology for the next five years. The partnership also includes an innovative strategy wherein the cost per test is increased (per annum) at the rate of 25% of the decline in incidence. This is the first kind of public procurement norm wherein the supplier of service has been incentivized to create an increase in access to care and decline in disease.
As the roll-out of Truenat continues, the partnership will be closely watched not just by TB stakeholders in other Indian states but the world as a whole. TB has officially been designated as the biggest global killer by an infectious disease since September 2015. If the Andhra Pradesh/Molbio partnership proves successful for the state as a cost-effective means to reduce TB, while delivering financial or reputational profit for Molbio, the hope is that it would catch on as a significant TB intervention globally.
To see India’s TB dashboard go here
To download the key targets and commitments of the recent UNHLM on TB go here