“As long as millions of people live with the disease without treatment and continue to transmit the infection to others, the world will not end TB as an epidemic.” Recognizing that roughly 40% of TB cases worldwide are not yet detected, the Global Fund encourages applicants and implementers of TB-programs to develop innovative actions to find the missing TB cases. This is why programs are supported that address barriers to finding these missing cases of TB and expand the most successful tools and strategies. Global Fund also encourages adding TB screening to other routine check-ups during medical visits. CCMs, PRs and TB programs in high burden countries commonly include in their grant applications dCXR/CAD in combination with Xpert® MTB/RIF to boost active case finding and to measure the impact of Global Fund supported TB programs, through prevalence surveys for which CXR is mandatory

Principal recipients, implementers and applicants for Global Fund funding can include budgets for digital X-ray systems provided the policies and principles on good Procurement and Supply Management are applied; sufficient, quality assured, transparent, at the lowest price, reliable, timely and in line with national and international laws. These are key elements in the Global Fund policies. Total cost of ownership (TCO) should be taken into account for medical equipment like digital X-ray (please refer to cost savings section on this site for full details on TCO). The rules may require the principal recipient to amortise the investment over the grant period. Also a plan for post grant period use is crucial to justify the capital investment. For instance a number of NTP´s indicated to use digital radiology systems at prison sites or at hospitals after the TB prevalence survey is completed. Multifunctional X-ray systems can also generate revenues for facilities through fees paid by non-TB patients.

To facilitate access for NTP's in low and lower-middle income countries to digital radiology access pricing from manufacturers can, at times, be obtained. For both the system (base and mobile) and comprehensive services during 3 and 5 years reduced and fixed prices can be made available making inclusion of digital X-ray in Procurement and Supply Management plans easier, please refer to the Pricing section for more details. CheckTB! is developing with stakeholders innovative financing solutions such as a Revolving Diagnostic Imaging Fund using a pooled procurement set-up. NTP's can then draw imaging rights on the basis of pay per image during e.g. 3 or 5 years. This also facilitates access to digital technology through Performance Based costing models.