ABSTRACT
To contribute to tuberculosis (TB) elimination, TB preventive treatment (TPT) should integrate innovative approaches including tele-contact investigation (TCI), mathematical modelling, and participatory governance. Aligning with the World Health Organisation's primary health care framework, supply is provided by the provincial health system, demand is cultivated by the community, while governance is represented by the governor, who oversees the health leadership structure, local policies, and allocation of resources. A healthy dynamic between these three components is required to achieve universal health coverage (UHC). Because of their potential to integrate health systems and engage communities, primary health care principles underpin an effective approach to TB prevention. First, the provincial health system should connect with the community through TCI to transform the status quo of passive service delivery. Second, community participation should strengthen the linkage between the health system and governance, which ensures that community action plans are aligned with provincial TPT targets. Third, governance should leverage mathematical modelling to allocate resources to those with greatest need. Central to this is a reliable TB information system that should validate a robust mathematical model to measure cost-effectiveness of the intervention. Collectively, this holistic approach to TB prevention could provide a proof-of-concept that investing in primary health care is the key to UHC.
