7 Private-Sector Models Transforming HIV, TB, Malaria & Health Systems Strengthening at Scale

Traditional public health systems face challenges in keeping pace with rising disease burdens and declining donor funding. In low- and middle-income countries, facility-based approaches cannot meet the scale of need, particularly in rural and underserved communities where infrastructure and workforce capacity remain constrained.

Technology-enabled private-sector delivery models offer a transformative solution. By leveraging existing commercial infrastructure, integrating services across disease areas, and linking payment to verified outcomes, these innovations demonstrate new pathways to expand coverage while improving cost-effectiveness and quality. The question is no longer whether private-sector engagement is needed, but how to scale promising models effectively while maintaining quality and equity.

This report, “7 Private-Sector Models Transforming HIV, TB, Malaria & Health Systems Strengthening at Scale”, profiles innovations operating across Sub-Saharan Africa and Asia that are delivering measurable results. These models span virtual care platforms, pharmacy networks, and digital adherence systems, demonstrating that private-sector approaches can achieve national-scale impact.

The report examines 7 distinct delivery models:

Virtual Care Delivery for HIV Prevention

1. MYDAWA (Kenya, Uganda): Virtual care platform achieving 92% treatment initiation rates while reaching 63% male users and delivering post-exposure prophylaxis within 39 hours.

Digital Systems for TB Care at Scale

2. Everwell Health Solutions (17 countries across Africa, Asia, Europe): Digital case management supporting 18 million person-episodes annually, with 50+ million registered users and US$350 million in direct benefit transfers processed through India’s Ni-kshay system.

3. SwipeRx (Southeast Asia): Mobile continuing professional development platform reaching 13,840 pharmacy professionals at 55,000 outlets in 12 months, with 79% women providers and 90% operating outside capital cities.

Pharmacy-Based Delivery for Malaria Treatment

4. Maisha Meds (Nigeria, Kenya, Tanzania, Uganda, Zambia): Test-before-treat programs through 4,500 private pharmacies quadrupled rapid diagnostic test use (8% to 33%) at US$3.20-4.00 per patient versus US$8-12 historical costs, while handling 1.9 million monthly visits.

5. Sproxil (Nigeria, Kenya, India): Product authentication systems deployed on 4.5 billion units, reducing antimalarial failure rates from 20% to 1.3% while generating real-time surveillance data across 500+ health indicators.

Integrated Platforms for Health Systems Strengthening

6. Field Intelligence (Nigeria, Kenya): Supply chain platforms reducing stockouts from 52% to 23% across 35,000 facilities, including a 70% reduction in contraceptive stockouts, while achieving 96% on-shelf availability in the private sector through vendor-managed inventory.

7. Elephant Healthcare (Nigeria, Kenya, Pakistan): Offline-first electronic medical records supporting 19 million patients across 3,600 facilities, cutting wait times by 20-40% with patient micro-payments covering installation and maintenance costs.

What This Means for Health Systems

These 7 delivery models highlight opportunities to expand coverage and improve cost-effectiveness across health systems. Key insights:

• Existing commercial infrastructure, including private pharmacy networks, e-pharmacies, and digital platforms already serving millions, can rapidly expand disease-specific coverage when integrated into national service delivery plans.
• Cross-disease integration through unified digital platforms reduces program fragmentation and administrative costs while improving the patient experience across HIV prevention, tuberculosis screening, malaria case management, and health systems interventions.
• Results-based contracting models create opportunities to shift from input-based financing toward verified results, enabling technology-enabled models compete on delivery outcomes and cost-effectiveness.

To learn more, explore the full report for insights from all 7 innovations and their implications for health systems strengthening.  A French version is also available here.

Project Team

This work was led by Anton Kannemeyer, Oladunni Lawal, Deji Ogunye, Tosin Oshinubi, and Mara Hansen Staples, all at Salient Advisory. Special thanks to our partners at The Global Fund to Fight AIDS, Tuberculosis, and Malaria and the Gates Foundation, who provided support.