The Global Fund has been the largest donor to Pakistan in bridging the gap for TB funding in the country. There are three Principal
Recipients (PRs) for the implementation of the TB Control activities in Pakistan funded by the Global Fund. The public sector PR is National TB
Control Program (NTP) and the private sector PRs are Mercy Corps and The Indus Hospital Network.
At national level NTP provides overall leadership and technical guidance to all TB control initiatives in the country. NTP is supported by the
Provincial TB Control Programs (PTPs) in each province. The PTPs supervise and monitor the implementation of TB control activities at the
provincial level. At the district level, the activities are implemented under the supervision of District TB Coordinator (DTC), who is supported
by the District Lab Supervisor (DLS).
Mercy Corps is a non-profit international non-governmental organization, which has been operational in Pakistan since 1986. It is improving
livelihood, increasing access to health care and helping communities recover from emergencies. Mercy Corps has been the PR of The Global
Fund for TB Control activities in the private sector since 2007. Mercy Corps is working in close coordination and collaboration with National
and Provincial TB Control Programs, contributing to the overall national case notification of TB cases. Through its partners, Mercy Corps
implemented the Public-Private Mix (PPM) project across the country by engaging private sector’s healthcare providers for the provision of
quality TB diagnosis and treatment. Under the New Funding Request (NFR) grant of the Global Fund, Mercy Corps continues to implement
PPM in 65 districts of Pakistan with six sub-recipients.
The allocation of districts according to the SRs in four provinces and three regions is tabulated below:
Pakistan is the world's sixth most populous country with an estimated population of 193 million and is ranked fifth amongst 30 TB high-burden countries in the world with an estimated 518,000 new TB
cases each year. The incidence rate is 268 cases per 100,000 population, prevalence rate is 342 cases per 100,000 population and overall TB mortality rate is 23 deaths per 100,000 population.
Pakistan is also one of the top 10 highest multidrug-resistant (MDR) TB burden countries with an estimated 15,000 MDR TB cases among notified pulmonary TB cases.
The WHO targets for TB are 90% of the TB cases to be detected and 93% of the detected cases to complete their treatment successfully. In 2016, there were 366,061 all type TB cases notified in
Pakistan, giving an estimated treatment coverage (notified/estimated incidence) of 70% with treatment success rate of 91%. However, there is still an estimated annual short fall around 145,000
incident TB cases. This huge pool of undetected or “missing” TB cases is a cause of great concern for the national and provincial TB control programs and international partners. It is highly likely that
these active, incident TB cases are neither properly diagnosed nor receive quality care. Furthermore, these cases will often face a long delay before they are eventually diagnosed.
These missing cases form the basis of strategic priorities for Mercy Corps and the organization has been striving to detect these missing through active and passive case finding interventions coupled
with enhance case finding approaches in 65 districts of Pakistan in the Global Fund’s New Funding Request (NFR) grant.
GFATM Round 8 (Bridging the Gap for TB