Staying ahead of the curve: a decade of a sustainable public-private synergy for TB elimination in Haryana, India.
Authors
Affiliations (15)
Affiliations (15)
- Department of Respiratory and Sleep Medicine, Medanta - The Medicity, Gurgaon 122001, Haryana, India.
- Find and Treat, University College London, London NW1 2PG, UK.
- Department of Respiratory Medicine, Scarborough General Hospital, Scarborough YO12 6QL, UK.
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur 441108, Maharashtra, India.
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA.
- Institute for Global Health, University College London, London WC1N 1EH, UK.
- State Tuberculosis Office, Panchkula 134109, Haryana, India.
- Civil Hospital, Ambala 134003, Haryana, India.
- District Tuberculosis Office, Karnal 132001, Haryana, India.
- District Tuberculosis Office, Bhiwani 127021, Haryana, India.
- District Tuberculosis Office, Sonipat 131001, Haryana, India.
- Retired Civil Surgeon, Civil Hospital, Sonipat 131001, Haryana, India.
- District Tuberculosis Office, Gurgaon 122001, Haryana, India.
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK.
- Department of Cardiothoracic and Vascular Surgery, Medanta - The Medicity, Gurgaon 122001, Haryana, India.
Abstract
Achieving the goal of tuberculosis (TB) elimination in India requires innovative approaches. The TB-Free Haryana Mission is a decade-long public-private partnership (PPP) between the government of Haryana state and Medanta - The Medicity, a tertiary corporate hospital designed to strengthen TB case detection and care, particularly among underserved populations. Launched in 2014 as a pilot in Rewari district, the initiative scaled statewide by 2019 using a mobile diagnostic model that integrated digital chest X-ray screening, sputum microscopy and rapid molecular testing. Over time, point-of-care molecular diagnostics and AI-assisted chest X-ray interpretation were incorporated to enable same-day diagnosis and treatment initiation. Over 10 years, the Mission performed >62 000 chest X-rays, achieving an overall high diagnostic yield (5.3%) and extending access to quality diagnostics in remote rural settings. The approach improved detection of smear-negative TB, reduced delays between diagnosis and treatment and remained operationally effective even during the COVID-19 pandemic. Long-term sustainability was supported through shared funding, continuous technological upgrades, strong monitoring systems, community engagement and alignment with national TB policies. This experience demonstrates that a technology-enabled, domestically funded PPP model can effectively bridge diagnostic gaps and is scalable for replication to accelerate TB elimination efforts in India.