Tuberculosis is one of the world’s biggest healthcare emergencies and an epidemic of catastrophic proportions. Therefore, every government has declared its commitment to solving the problem. However, the resulting efforts have had only limited success, particularly in developing countries, due to lack of infrastructure, insufficient manpower and a paucity of funds. And as these gaps in the public health systems continue to persist, they continue to preclude a true containment of the disease.
Our first partner organization from India was founded to address these very gaps. In 2005, the founders discovered that tuberculosis medicines worth several million dollars had simply expired in Indian warehouses, because the infrastructure was insufficient to distribute these free drugs to the people that really need them – in the slums. Patients had to travel to distant hospitals, which represented costs and time demand, which the impoverished patient – already unable to work because of the disease – could not meet.
Furthermore, in developing countries public health infrastructure frequently lack sufficient capacity in urban areas, where healthcare centers are often too understaffed and existing staff members too overworked in order to provide proper TB treatment.
In contrast to this in rural regions the public clinics and hospitals often keep uncertain and unreliable opening hours (i.e., open for only 2-3 days a week and for only about 4 hours a day), so that patients are denied the ability to obtain free, proper TB treatment.
Since the governments alone do not seem to be able to fix these infrastructure deficiencies in time, in our choice of partner organizations we try to ensure that they are committed to operate locally and provide aid directly to those affected.
Because of inadequate infrastructure and financial support from the public health sector in developing countries, patients often escape into the private sector. There, however, many patients also encounter a number of pitfalls and issues that we briefly discuss in the next section.