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

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.