Innovation dynamics in Tuberculosis control in India: The shift to new partnerships
Nora Engel
#2009-040
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.
Keywords: Innovation dynamics, public-private mix, Tuberculosis, India
JEL code classification: I18, O31, O38
UNU-MERIT Working Papers
ISSN 1871-9872