Business as usual case finding interventions will not lead to any significant improvement in detecting and notifying additional people with TB, as TB notifications have mostly remained stagnant over the past ten years. With the ambitious SI target of an additional 1,5 million people with DS-TB and DR-TB notified by the end of 2019, the principles and process of the Strategic Initiative must be bold.

The SI partners are taking an approach from a people’s perspective and patient-centered care. People are followed in their health seeking efforts, for example, in settings where most people seek diagnosis and treatment in the private healthcare sector, case finding interventions must ensure that private healthcare providers become more engaged in providing quality TB health services and are linked to the national notification system for adequate treatment and surveillance. This is just one example to illustrate that information is available on different health-seeking behaviors and how case finding interventions must be tailored to the different local and epidemiological contexts.

Although more systematized information on health seeking behavior of people with TB is increasingly available, such as through prevalence surveys or patient pathway analyses, insufficient data remains for many high-risk groups, their overall TB burden as well as their health-seeking behavior.

 To successfully detect many more people with TB, the Strategic Initiative seeks to help countries answer the following cardinal questions:


Who are the missing people with TB?

Where are the missing people with TB located?

Why are the missing people with TB not diagnosed and notified and linked to adequate treatment?

What can be done to find the missing people with TB?


With countries’ Global Fund approved TB case detection plans, the Strategic Initiative partners follow their intervention approaches. SI partners will support their operationalization, share experiences and best practices as well as help countries to monitor their implementation and impact, and course correct interventions where necessary to generate more impact.

To generate impact and find many more of the currently missing people with TB, at least three things must happen and be tracked:

1. Test many more people

2. Diagnose more TB both with better diagnostics and clinically (especially for children)

3. Improve the notification systems to capture those already treated in the private sector