Financing the Control of Tuberculosis
South Africa has the third-highest incidence of TB in the world after China and India. It also has the second-highest incidence of MDR-TB after India; in 2013, that incidence was 860 per 100,000 people. Within South Africa, a high concentration of TB patients work in the mining industry, which in 2013 employed more than 500,000 direct workers and another 500,000 indirect workers and where TB rates currently run as high as 2,500–3,000 per 100,000 workers, or 10 times the WHO designation for a health emergency.
This Lab was designed to delve deeper into specific funding gaps and financing models that were explored in the April 2015 Lab, New Partnership Models to Address Tuberculosis. Participants discussed the largest funding gaps in TB financing and the types of collaboration and funding that are attractive at each stage of the value chain. The Lab used South Africa’s gold mines as the context in which to build a pilot project to implement one of the following proposed models:
- Micro-levies or taxes on some part of the gold market to help fund TB prevention and treatment.
- Social Impact Bonds to monetize cost savings from a reduction in cases of the disease as a payout for investors in a service intervention program.
- Pooled Donor Trust to distribute grants to organizations to meet R&D needs for TB, specifically coordinating among mining companies and other extractive industries.
- Investment Guarantees and Loan products to fund parts of the TB value chain that could generate profit, such as vaccines or diagnostics.