Innovation Dynamics in Tuberculosis Control in India: The Shift to New Partnerships

Innovation dynamics in Tuberculosis control in India: The shift to new partnerships Tuberculosis remains the biggest infectious killer in India and worldwide, and it has recently regained substantial international attention with its come-back in drug resistant forms. The environment, the disease and the societal response to it are changing and with it challenges and opportunities to control the disease. Innovation in a variety of areas such as improved diagnostic tests, drugs, delivery mechanisms, service processes, institutions and treatment regimes is needed in order to be able to respond to the changing public health challenge. Recent developments in the literature emphasize that innovation is a complex endeavour that includes processes of negotiation, learning and alignment amongst researchers, health practitioners, firms and public authorities. The ground level realities for innovation in countries such as India where TB is a social as much as a clinical problem are complicated with challenges and constraints inherent to the health and wider social system that hamper learning, experimenting and thus innovation. Based on preliminary results from qualitative fieldwork in India this paper will examine the innovation dynamics in one of the recent policy changes in TB control in India: the emergence of new partnerships between private medical providers, NGOs and the government. The paper traces where new ideas come from, how they make their way through the existing control structure and how the existing efforts to control TB respond to and cope with these new developments. The central argument is that the dynamics of innovation in a complex, conflicting and confusing setting like TB control can be understood as a continuous evolution of problems, promises and solutions.