Financing the Control of Tuberculosis
Recent epidemics of infectious disease, including Ebola in West Africa and swine flu in India, have brought to international attention the sudden debilitation of whole communities and the economic impact this can wreak on global growth. Headline-grabbing public health crises have pushed tuberculosis (TB) out of the spotlight, despite the fact that two billion people—roughly a third of the world’s population, and mostly in poorer countries—carry TB bacteria in their systems as they go to work, to school, and back home again to their families. It takes little more than a cough or sneeze to infect an additional 10 to 15 people. The disease is a leading cause of death in certain populations; in 2013 alone, more than 1.5 million people died from TB.
Given the complexities of an airborne disease like tuberculosis, coordination among national and international agencies and organizations is critical. This is a disease that knows no borders; yet collaboration in vigilance for detection, containment, and treatment plans must be shared across a nation, a region, even across continents. This kind of effort takes significant capital expenditure. An estimated $2 billion annual funding gap remains for prevention, diagnosis, and treatment programs. Traditional donor funding and domestic resource allocation are not enough. The solution will likely be found in a better mix of public and private capital, including new types of financing options that attract institutional investors—from pension funds and sovereign wealth funds to family offices and endowments.
The Milken Institute organized two Financial Innovations Labs, in London and Johannesburg (South Africa’s TB rates are among the highest in the world), to bring together investors, donors, global health experts, government leaders, and industry executives to discuss innovative financing options that could attract new and smarter money for TB control. The first Lab resulted in a list of prioritized options; the second use South Africa’s gold mines as the context in which to build a pilot project to implement one of the models. This report summarizes the outcomes from the two sessions, including a road map for moving the models forward, with specific structural elements to solicit further discussion and feedback.