A strong smell from the nearby Deonar garbage dumping ground hits you as you walk through Kamla Raman Nagar slum in Baiganwadi. On both sides of a narrow lane are several small scale industries recycling waste. For Dr Gauhar Ali Shaikh, a Unani practitioner in the neighbourhood, skin infections and cough are routine complaints. “Malnutrition is very common and there is a Tuberculosis patient in every second household,” he says. Most of these patients stop seeking care if Dr Shaikh recommends that they visit the nearby government hospital. “Lack of money and the long lines scare them away,” he says.
Mumbai’s unique public-private partnership TB model, the Private Provider Interface Agency (PPIA) is addressing this gap. BMC and Path, a global NGO, joined hands in 2014 and mapped 15 high-burden TB wards in Mumbai. Step 2 was to engage with private doctors, chemists and diagnostic centres. Over 75 per cent of India’s population seeks private care. And with an estimated 28 lakh TB cases, an effective fight against it would not be possible without engaging the private sector.
As part of these efforts, like many private practitioners, Dr Shaikh has been given a list of private diagnostic centres where his TB patients can get tests done for free. He also generates a voucher that patients can show at a chemist shop that is part of the network to claim medicines. The chemists are later compensated by the Path.
The high cost of treatment means that patients drop out. With a highly contagious infection like TB, even one patient drop-out risks lives of those around, especially in communities where nutrition levels are abysmally low.
It was this system that made Ishrat Parveen’s recovery from TB possible last year. The 16-year-old caught the infection from her niece who stayed with the family for a few days in their 100-sq-ft home in Baiganwadi that has no windows. “I went to Dr Vikas Oswal at his nursing home in Govandi, and he gave me the medicines,” says the teenager.
Dr Oswal, along with Dr Zarir Udwadia, has been consistently working to draw attention to the rising number of drug-resistant cases in Mumbai.
With the model showing results, as part TB elimination strategy 2025, the Centre has announced that this PPIA model be replicated across the country.
“There are an estimated one million ‘missing’ TB cases in India. PPIA’s interventions have demonstrated a comprehensive and systematic approach to engage with the private sector for TB control. The pilots have achieved significant results,” sums up PATH project director Shibu Vijayan.
The Mumbai Model
TB patients diagnosed and notified since 2014
43,289
Number of healthcare providers in the network
3,670
Hub hospitals in the network
648
MDR-TB cases diagnosed
3,640
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