Thank you Tony! These are really interesting and tough questions.
We certainly see a potential route for government as a doer and payer at scale.
Re payer: we’ve seen examples in Pakistan where he government outsource service provision in both education and health to NGOs - so NGOs deliver but government pays.
Re doer: when there is a strong community based health worker force it’s more possible to layer TB into what they do. There are some alternatives to consider e.g. Commcare Connect https://labs.connect.dimagi.com/ to essentially allow government staff to pick this up as gig work. But we haven’t looked into these a tonne yet.
I think the routes here are most promising in Punjab province and potentially other countries.
However, with the advent of the third wave of philanthropy the time pressure to handover to government as the payer at scale I think has lessened. I’m interested in your take on this too. It does seem possible to me that providing this intervention support directly in Sindh and elsewhere funded by philanthropy could be a more viable route than it has previously been. Right now I think that actually means viability of different funding sources is probably my biggest uncertainty to shed light on the best scaling strategy.
Thank you Tony! These are really interesting and tough questions.
We certainly see a potential route for government as a doer and payer at scale. Re payer: we’ve seen examples in Pakistan where he government outsource service provision in both education and health to NGOs - so NGOs deliver but government pays. Re doer: when there is a strong community based health worker force it’s more possible to layer TB into what they do. There are some alternatives to consider e.g. Commcare Connect https://labs.connect.dimagi.com/ to essentially allow government staff to pick this up as gig work. But we haven’t looked into these a tonne yet. I think the routes here are most promising in Punjab province and potentially other countries.
However, with the advent of the third wave of philanthropy the time pressure to handover to government as the payer at scale I think has lessened. I’m interested in your take on this too. It does seem possible to me that providing this intervention support directly in Sindh and elsewhere funded by philanthropy could be a more viable route than it has previously been. Right now I think that actually means viability of different funding sources is probably my biggest uncertainty to shed light on the best scaling strategy.