PSI’s tuberculosis (TB) programs seek to strengthen the role of the private sector in reducing TB incidence and ensuring successful TB treatment completion.

In the commercial sector, franchising has proven to be a highly successful way to replicate a proven business model and efficiently respond to consumer demand for services and products of a specified standard. In recent years, the social sector has applied the same business principles to health service delivery with the goal of improving quality of life rather than generating profit. This business model, referred to as "social franchising," responds to a need for more and better regulated essential health care services that people can afford.

IMPACT: A new Global Health Initiative (GHI) Executive Director, Lois Quam, has recently been named. What will be the organizational relationship between USAID's Global Health Bureau and the Executive Director?

IMPACT: What are some of the overarching issues that threaten progress on global health challenges like malaria, HIV/AIDS, tuberculosis, reproductive health and child survival?

The United States has a long history of helping people in need, in countries around the world. At times, this has meant helping a nation recover from a disaster or helping families access basic food and shelter to survive. In 1961, with Americans feeling increasing dissatisfaction with the foreign assistance structures that were currently in place, President John F. Kennedy reorganized U.S. foreign aid programs and created the U.S. Agency for International Development (USAID) by executive order.

Ashwini, an 18-year-old garment worker in Bangalore, contracted tuberculosis (TB) several months ago. Factory workers like Ashwini tend to be at high risk of TB infection due to overcrowding and poor ventilation in their working and living spaces.

In its early years, PSI focused on marketing condoms – a family planning product that required no clinical or technical support. As it has moved into new health areas, PSI has expanded its programs to include health products and services that require the involvement of doctors, nurses, pharmacists and village health workers.

Most often these services are provided by branded networks of local health workers who are trained, supported, monitored and subsidized by PSI as part of a social franchise.

KARL HOFMANN: Dr. Shah, you are working to make sure USAID projects are moving toward an endpoint; essentially hoping to put USAID out of business in the long run. Is one of the ways in which countries will move toward self-sufficiency in health care provision by increased provision of health products and services through the private sector?