Despite widespread use of private providers for the diagnosis and treatment of tuberculosis (TB), the quality of care in the private sector is hindering efforts to improve TB outcomes. TB remains the ninth leading cause of death worldwide, and efforts to drive improvements have been largely focused on the public sector. Across the top 30 high-burden countries (HBCs), the private sector plays a significant role in the diagnosis and treatment of patients with both drug-sensitive and drug-resistant TB. Yet quality of TB care provided in the private sector is inconsistent and inadequate, negatively influencing TB outcomes.

ThinkWell, with the support of the Bill & Melinda Gates Foundation, has released a report offering a global review of high-level programmatic challenges seen in private sector TB care and the ways in which financing mechanisms can be used to address these challenges, drawing from lessons learned from other health areas. By identifying gaps in the status quo and proposing a theory of change to systematically influence how TB care is delivered in the private sector, there is significant opportunity to harness the private sector for quality service delivery. Catalytic investment to support governments in using strategic purchasing mechanisms, coupled with deliberate investment to purchase high-quality TB services from targeted private providers in alignment with national quality and regulatory standards, will lead to improved TB outcomes.

To read our full report and recommendations, click here.

Have you ever wondered what it costs to deliver the HPV vaccine in schools in Indonesia? Are you looking for evidence on operational costs to inform your country’s immunization program? Have you been searching for the cost of mobile vaccine delivery in Uganda, Peru, or Bangladesh? Our new and improved set of resources has this information and more. Explore it all on our website, Here you’ll find:

  • A standardized and richly annotated Immunization Delivery Cost Catalogue (IDCC) of the data extracted. The IDCC (Excel workbook and web tool) includes 410 unit costs (i.e. cost per capita, dose, fully immunized child, full immunization of a vaccine, or person in the target population), all presented in 2016 US dollars for easy referencing and use.
  • A summary report of immunization delivery cost findings. The report describes the spread and scope of the evidence, methods, and resources, including a quality assessment of the resources captured in the systematic review.
  • A set of immunization delivery cost ranges for vaccine delivery through a variety of strategies and in a range of contexts. These estimates of cost per dose and cost per fully immunized child combine four or more comparable unit cost estimates into a single cost range with other descriptive statistics noted.
  • Companion interpretive products (e.g., detailed methodology note and user guides)

Across these resources, we’ve added new data, addressed feedback obtained from user research, and considered new approaches to analyzing the data. The changes are meant to better equip you—whether you’re a policymaker, researcher, or international partner—with evidence to guide country and global immunization and health system policy, planning, advocacy, etc.


In May 2018, ThinkWell released findings from a systematic review of the evidence base on immunization delivery costs (IDC) in low- and middle-income countries (LMICs). The review aimed to answer a question frequently asked by global and country immunization stakeholders: What are the unit costs of vaccine delivery across different LMICs and through a variety of delivery strategies?

The review and a subsequent refresh considered over 15,000 resources published between January 2005 and January 2018 on the topic. Ultimately, the review drew from 61 resources with IDC data on a variety of vaccines, delivery strategies, types of cost analysis, and settings.

Want to Learn More?

How-to guides and videos with instructions on using all tools and products are also available at

Immunization Costing Action Network (ICAN)

Led by ThinkWell and John Snow, Inc. (JSI), the Immunization Costing Action Network (ICAN) is a project focused on increasing the visibility, availability, understanding, and use of data on the cost of delivering vaccines. ICAN aims to build country capacity around generation and use of cost information to work towards sustainable and predictable financing for vaccine delivery.

How can budgets be reformed to facilitate progress towards UHC? If you want to learn more on improving budget formulation, execution, and reporting in health, please join the new WHO six-part webinar series on Leveraging Public Financial Management for Better Health. The webinar series, facilitated by ThinkWell, will be conducted from May to November 2019, with one budget topic addressed each month:

  1. Introduction – Role of PFM functions and reforms from a health sector perspective
  2. Budget formulation issues in the health sector: key issues for policy makers
  3. Budget execution issues in the health sector: challenges and policy responses
  4. Links between budget reforms and provider payment systems: what is at stake?
  5. Budget accountability: financial transparency and accountability towards sector outputs
  6. Budgeting for health in devolved settings

Each webinar session will be 70 minutes long, and will include a technical presentation, country illustrations, as well as time for questions and answers.

This webinar series is primarily addressed to planning and budgeting units at health ministries, social sector units at finance ministries, but other partners can join as well.

Registration is based on open-enrollment, but spaces are limited. Read more and register here.